Liver Disease and Pregnancy

Tram T. Tran, MD, FACG, FAASLD1, Joseph Ahn, MD, MS, FACG2 and Nancy S. Reau, MD, FAASLD, FAGA3

1Department of Medicine, Liver Transplant, Cedars Sinai Medical Center, Los Angeles, California, USA; 2Department of Medicine, Oregon Health & Science, University, Portland, Oregon, USA; 3Department of Medicine, Rush University, Chicago, Illinois, USA

Am J Gastroenterol advance online publication, 2 February 2016; doi: 10.1038/ajg.2015.430
Received 7 September 2015; accepted 17 December 2015

Correspondence: Tram T. Tran, MD, FACG, FAASLD, Department of Medicine, Liver Transplant, Cedars Sinai Medical Center, Los Angeles, California 90048, USA. E-mail: TranT@cshs.org

Abstract

Consultation for liver disease in pregnant women is a common and oftentimes vexing clinical consultation for the gastroenterologist. The challenge lies in the need to consider the safety of both the expectant mother and the unborn fetus in the clinical management decisions. This practice guideline provides an evidence-based approach to common diagnostic and treatment challenges of liver disease in pregnant women.

Introduction

Management of pregnant women with liver disease is a common clinical scenario, and one that can be challenging given the need to consider not only the expectant mother, but also the unborn fetus in treatment decisions. The purpose of this guideline is to provide a review of the diagnostic and treatment challenges of managing liver disease in pregnant women. The evidence behind approaches to diagnosis and treatment of liver disease in pregnant women are assessed to provide management recommendations.

These recommendations are based on the following: (i) a search and review with analysis of the recently published world literature on the topic using Medline search from 1946 to present, EMBASE 1988 to present, and SCOPUS from 1980 to present using the search terms listed in the Appendix. (ii) Guideline policies of the ACG. Intended for use by physicians and allied health professionals, these recommendations suggest preferred approaches to the diagnostic, therapeutic, and preventive aspects of care. These are intended to be flexible and adjustable for individual patients ( 1 ).

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