Cirrhosis and pregnancy- a report of 2 cases

Abstract

Cirrhosis and pregnancy are a rare existence. A 35 year old G2P1L1 was admitted with 36 weeks of gestation and cirrhosis of the liver. The patient went into active labor the next day and emergency LSCS was done for fetal distress under GA. A live healthy female baby of 1.9kg was delivered. Her LFT was normal. HBsAg, HCV I and II were negative. Ultrasonography showed features suggestive of cirrhosis of the liver with portal hypertension, moderate congestive splenomegaly and moderate ascitis. Upper GI endoscopy showed portal hypertension with gastropathy. 
Discussion: Complications are common in cirrhotic patients. Bleeding esophageal varices(18-32%), splenic artery aneurysm rupture(2.65%), hepatic decompensation (24%), hepatorenal syndrome, hemorrhagic daiathesis and maternal deaths(10.3-18%) are known to occur. Obstetric complications such as spontaneous abortion (30-40%), preterm labor (25%), fetal growth restrictions, perinatal deaths (18%) and hemorrhagic disease in the new born have been encountered.