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Recommendations for pregnancies in patients with crigler-najjar syndrome
J H Paul Wilson1, Maarten Sinaasappel, Fred K Lotgering
1Department of Internal Medicine, Internal medicine, metabolic diseases Office D416 Erasmus MC, 2040, 3000 CA, Rotterdam, The Netherlands.
Abstract:
During pregnancy, the developing foetus in mothers with Crigler-Najjar type 1 and 2 is exposed to raised levels of unconjugated bilirubin, with the risk of neurotoxicity. We describe two pregnancies in a patient with Crigler-Najjar type 2, who was carefully monitored prior to and during pregnancy and phototherapy adjusted to maintain serum bilirubin levels below 200 μmol/l and the bilirubin/albumin molar ratio below 50%. Both pregnancies resulted in normal delivery of healthy infants who had normal neurological development. A review of all reported pregnancies in Crigler-Najjar patients and a set of recommendations are presented.
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