Introduction: Pregnancy in cirrhotic patients is rare due to endocrine disorders from chronic liver disease, which significantly reduce fertility. Cirrhosis during pregnancy also increases maternal and fetal risks. This study aimed to assess pregnancy outcomes in cirrhotic patients at our hepatology unit and investigate the impact of hypersplenism on these outcomes. Methods: This retrospective observational study was conducted from January 2014 to September 2024. Women diagnosed with cirrhosis (prior to pregnancy or during the first trimester) based on hepatic elastography or liver biopsy, and who received consistent prenatal and gastrointestinal care at our medical center, were included. Women with chronic liver disease without cirrhosis or irregular follow-up were excluded. Cases were divided into two groups: successful pregnancies and those resulting in fetal loss. Data were analyzed using Jamovi version 2.0.0.0 software. Qualitative data were reported as counts and percentages, and quantitative data as median (IQR) or mean (± standard deviation). Results: Nine pregnancies in cirrhotic patients were included. The median age was 27 years (range:26-31). Two pregnancies were successful, with thrombocytopenia, splenomegaly, and grade I esophageal varices in both cases. These were complicated by late prematurity, with instrumental vaginal delivery to minimize risks. Seven pregnancies resulted in fetal loss (median age: 29 years, range: 24-37). Obstetric complications included early and late spontaneous abortions, HELLP syndrome, and intrauterine fetal death. No maternal deaths occurred. Conclusion: This study underscores the challenges in managing pregnancies in cirrhotic women, particularly the role of hypersplenism, and highlights the need for careful monitoring and individualized care.
Benass et al. (Tue,) studied this question.