The possibility of introducing a normal pregnancy and delivery in patients with established liver cirrhosis
1 Maternity House, Erebouni medical center, Yerevan, Armenia.
2 Altamed Medical Group, Los Angeles, CA.
3 Hemophilia and Thrombosis department, Armenian Haematology center aft. prof. R.Yeolyan, Yerevan, Armenia.
Research Article
World Journal of Advanced Research and Reviews, 2021, 12(02), 621–625
Article DOI: 10.30574/wjarr.2021.12.2.0584
Publication history:
Received on 03 October 2021; revised on 27 November 2021; accepted on 29 November 2021
Abstract:
The management of pregnant women with portal hypertension is challenging. In the second trimester, examinations are performed to identify esophageal varices. There are no clear recommendations regarding the primary prevention of bleeding in case of esophageal varices in pregnant women and management in case of bleeding.
There are no recommendations on the preferred mode of delivery (vaginal or caesarean section) for portal hypertension. Since the persistent period is undesirable in the presence of varicose veins, it is recommended, if necessary, to shorten the second stage of labor by applying obstetric forceps or performing vacuum extraction of the fetus. In the presence of obstetric indications, a caesarean section is performed, which is also associated with certain risk; since cirrhosis often has varicose veins of the abdominal wall. In addition there is a tendency to bleed during childbirth, infectious complications, and slow wound healing.
Because of possible medical contraindications and difficulty of prenatal management and delivery of patients with established liver cirrhosis, there are many cases of patients concealing their diagnosis when planning pregnancy and visiting a gynecologist, which, undoubtedly, can lead to concomitant complications and serious consequences that threaten the lives of patients.
The clearest example of the above is the following patient case.
Keywords:
Pregnancy; Delivery; Liver cirrhosis, Outcome
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Copyright © 2021 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0