Document Detail


Pregnancy outcome in liver transplant recipients.
MedLine Citation:
PMID:  12850617     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate pregnancy course, complications, and outcomes in liver transplant recipients. METHODS: We conducted a retrospective review of 38 pregnancies conceived between 1992 and 2002 in 29 women who underwent liver transplantation at Mount Sinai Medical Center. RESULTS: The most common primary liver disease was autoimmune hepatitis. All patients were on immunosuppressive regimens that included cyclosporine A or tacrolimus. There were four spontaneous first-trimester abortions and ten first-trimester terminations for worsening liver function. The interval from transplantation to pregnancy was shorter in the group that had abortions and terminations (24.4 +/- 24.3 months) as compared with the group that had live births (47.8 +/- 28.7 months), P =.02. There were 24 live births to 20 patients. The mean gestational age at delivery was 36.4 weeks, and the mean birth weight was 2762 g. Pregnancy complications included preeclampsia (20.8%), chronic hypertension (20.8%), hemolysis, elevated liver enzymes, low platelets syndrome (8.3%), creatinine 1.3 mg/dL or more (25.0%), anemia (33.3%), diabetes (37.5%), cesarean delivery (45.8%), preterm birth less than 37 weeks (29.2%), intrauterine growth restriction (16.7%), and biopsy-proven graft rejection during pregnancy (16.7%). There were no intrauterine or neonatal deaths. All 5-minute Apgar scores were greater than 7. Four minor congenital anomalies were noted. Before 1997, there were five maternal deaths, 10-54 months after pregnancy. Pregnancy complications in our population were more common in those patients who delivered from 1992 to 1997 than in those who delivered from 1998 to 2002. CONCLUSION: Pregnancy planned at least 2 years after liver transplantation with stable allograft function can have excellent maternal and neonatal outcome.
Authors:
Sandor Nagy; Melissa C Bush; Richard Berkowitz; Thomas M Fishbein; Veronica Gomez-Lobo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-09     Completed Date:  2003-08-22     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  121-8     Citation Subset:  AIM; IM    
Affiliation:
Petz Aladar County Hospital, Gyor, Hungary.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / epidemiology
Abortion, Therapeutic
Adult
Analysis of Variance
Cohort Studies
Female
Fetal Death*
Follow-Up Studies
Gestational Age
Graft Survival
Humans
Incidence
Liver Transplantation*
Maternal Mortality / trends*
Pregnancy
Pregnancy Complications / diagnosis*,  epidemiology*
Pregnancy Outcome*
Pregnancy Trimester, First
Pregnancy, High-Risk*
Probability
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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