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首页> 外文期刊>Journal of clinical gastroenterology >Follow-up of pregnant women with autoimmune hepatitis: the disease behavior along with maternal and fetal outcomes.
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Follow-up of pregnant women with autoimmune hepatitis: the disease behavior along with maternal and fetal outcomes.

机译：自身免疫性肝炎孕妇的随访：疾病行为以及母婴结局。

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GOALS: To assess maternal and fetal outcomes and clinical management of pregnancy in patients with autoimmune hepatitis (AIH). BACKGROUND: There is a paucity of information about maternal and fetal outcomes, and AIH activity during pregnancy and in the postpartum period. There is no consensus about the administration of azathioprine during pregnancy and breastfeeding. STUDY: Retrospective analysis of 54 pregnancies (3 still in progress) in 39 AIH patients. RESULTS: The median age at conception was 24 years, and 68.4% of women had liver cirrhosis. Before conception and in early pregnancy, azathioprine and prednisone were administered in 48.1%, but treatment regimen was usually changed further to 20 mg/d prednisone; and 20.4% were off treatment. There were 36 livebirths, and fetal loss rates were 29.4% (13 miscarriages, 1 stillbirth, and 1 ectopic pregnancy). Preterm birth rate was 11.8%. In 2 cases, there was acute fetal distress; and in 2 others congenital malformations (3.9%). The rate of serious maternal complication was 7.8%, with no deaths. There were no flares in 41.2% pregnancies, but aminotransferase elevations occurred in 54.9%, 31.4% of which were true AIH relapses, only registered in the postpartum period. CONCLUSIONS: Despite the high fetal miscarriage rate, pregnancy in AIH was safe. Patients needed careful monitoring, especially in the postpartum period because of relapses. There was no evidence of a cause and effect relationship among azathioprine administration and premature births and congenital abnormalities, but more studies are necessary. Higher doses of prednisone may be an alternative option for those who prefer azathioprine withdrawal during pregnancy.
机译：目标：评估自身免疫性肝炎（AIH）患者的母体和胎儿结局以及妊娠的临床管理。背景：关于孕产期和胎儿结局以及怀孕期间和产后AIH活动的信息很少。关于在孕期和哺乳期服用硫唑嘌呤尚无共识。研究：对39例AIH患者中的54例妊娠进行回顾性分析（3项研究仍在进行中）。结果：受孕中位年龄为24岁，其中68.4％的女性患有肝硬化。在怀孕前和妊娠早期，硫唑嘌呤和泼尼松的比例为48.1％，但通常将治疗方案进一步更改为泼尼松20 mg / d。和20.4％不接受治疗。有36例分娩，胎儿丢失率为29.4％（流产13例，死产1例，异位妊娠1例）。早产率为11.8％。 2例出现急性胎儿窘迫。和另外2个先天性畸形（3.9％）。严重的母亲并发症发生率为7.8％，无死亡。 41.2％的孕妇没有发生耀斑，但转氨酶升高的发生率为54.9％，其中31.4％是真正的AIH复发，仅在产后期间出现。结论：尽管胎儿流产率很高，但在AIH中妊娠是安全的。病人需要​​仔细监测，尤其是在产后由于复发。没有证据表明硫唑嘌呤给药与早产和先天性异常之间存在因果关系，但是有必要进行更多研究。对于那些希望在妊娠期间戒断硫唑嘌呤的人，高剂量的泼尼松可能是另一种选择。

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