Pregnancy in liver cirrhosis and/or portal hypertension

Clinical features of pregnancy in women with liver cirrhosis and/or portal hypertension have been reviewed. Termination of pregnancy is seldom indicated in a woman with compensated cirrhosis or a young woman with extrahepatic venous obstruction. However, the risk of spontaneous abortion is increased in cirrhotic women without shunt even if there is no deterioration of liver function. The risk of bleeding from esophageal varices or deterioration of liver function is usually unpredictable. Shunt surgery can be done with relatively little effect on both the mother and the fetus if conservative measurements fail to control the hematemesis. Vaginal delivery can be anticipated in most women, and cesarean section should be preserved for obstetric indications. The risk of postpartum hemorrhage is greatly increased, particularly in patients with previous shunt surgery. Perinatal loss is high because of the increased rate of premature delivery and stillbirth. Maternal prognosis is grave in women with cirrhosis.