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Pregnancy associated with primary hepatocellular carcinoma
1Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
Background:
Hepatocellular carcinoma is a rare complication of pregnancy.
Cases:
Three cases of pregnancy complicated by primary hepatocellular carcinoma were seen at our hospital in 3 years. Two were diagnosed antepartum and one postpartum. In one instance, the diagnosis came from finding elevated maternal serum alpha-fetoprotein (MSAFP) with normal amniotic fluid (AF) AFP. Positive hepatitis B surface antigen and liver cirrhosis were found in all three cases, but liver enzymes were only slightly elevated. All three women died, as did one of the fetuses.
Conclusion:
Careful MSAFP screening and interpretation, followed by AFAFP and abdominal sonography, seem to be the best tools for early diagnosis of primary hepatocellular carcinoma in pregnant women.