PREGNANCY IN CHRONIC ACTIVE HEPATITIS

  • 1 January 1979
    • journal article
    • research article
    • Vol. 48  (192) , 519-531
Abstract
The outcome of pregnancy in chronic active hepatitis (CAH) was studied retrospectively, together with a survival analysis of patients and a comparison of fertility with that expected from controls drawn from the normal Australian population. Clinical records of 73 cases of CAH included 37 women who were potentially fertile (aged 15-45 yr) and there were 30 pregnancies among 16 of these women. Hepatic and obstetric complications and the outcome for the fetus and the mother were compared with the results from 36 reports accumulated from the literature. An incremental increase in survival of patients with CAH was seen according to decade of diagnosis from 1950 and similar severity of liver disease in those who did, or did not, become pregnant. Fertility was reduced in patients with CAH. Relapse of CAH occurred during pregnancy in only 2 patients, hepatic complications were minimal and there was no consistent pattern of alteration in liver function; 12 of 16 mothers are alive for a mean period of 8 yr after pregnancy. Obstetric complications included urinary tract infections (6), toxemia of pregnancy (9) and prematurity (7); of the 30 pregnancies, 4 were terminated on medical advice in the early years of the study, 3 ended in spontaneous abortion and there were 4 perinatal deaths giving a fetal loss rate of 33%. Despite the maternal disease and use of prednisolone and azathioprine during pregnancy, the single congenital abnormality was pyloric stenosis. In CAH fertility is reduced but pregnancies which occur can proceed without detriment to the mother provided that prednisolone treatment is maintained; a higher than normal fetal loss can be expected and babies may be born prematurely but will be normal.