Cirrhosis and Pregnancy

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Cirrhosis is the build-up of scar tissue in the liver that occurs as a result of chronic injury to the liver. Cirrhosis can be caused by many types of liver diseases and conditions, including infections (hepatitis) and alcoholism. Cirrhosis is usually irreversible, and if the damaging scar tissue continues to accumulate, the liver will eventually not be able to function normally. A liver that is not functioning well can be a life-threatening situation.

Symptoms of cirrhosis

Symptoms of cirrhosis usually don’t appear until the liver has already undergone extensive damage. Common signs and symptoms of cirrhosis include the following:

  • Fatigue
  • Easy bleeding or bruising
  • Loss of appetite
  • Nausea
  • Swelling of legs, feet, or ankles or the abdomen
  • Itchy skin
  • Jaundice
  • Spider-like blood vessels on your skin
  • Redness on the palms of your hands

Causes of cirrhosis

Many diseases and conditions that affect your liver can lead to cirrhosis:

  • Chronic alcohol use and abuse
  • Chronic viral hepatitis (caused by hepatitis B, C, or D virus)
  • Fat accumulating in the liver
  • Iron accumulating in the body
  • Cystic fibrosis
  • Copper accumulating in the liver
  • Malformations in the bile ducts
  • Inherited disorders of digestion or metabolism
  • Autoimmune diseases
  • Some medications, including methotrexate and isoniazid

You are at increased risk for developing cirrhosis if you drink too much alcohol, are overweight, or have viral hepatitis.

Preventing cirrhosis

The best way to prevent cirrhosis is to keep your liver healthy. You can do this by eating a healthy diet, engaging in plenty of physical activity, consuming alcohol in moderation (if at all), and reducing your risk of contracting viral hepatitis (e.g., do not share needles or personal hygiene items, do not have unprotected sex.)

Cirrhosis during pregnancy

Pregnancy is relatively uncommon in women with cirrhosis due to infertility related to the liver dysfunction; cirrhosis is also rare in women of child-bearing age. However, with improved treatments (as well as the fact that cirrhosis may take years before causing symptoms and therefore being diagnosed), more and more women with cirrhosis are getting pregnant. But, when pregnancy does occur, it puts the mother and baby at risk for serious and potentially life-threatening complications.

Most women who have cirrhosis before they get pregnant will experience a worsening of symptoms and liver-related complications, including premature birth, intrauterine growth restriction, and death. Mothers with cirrhosis will need to work with a team of specialists during pregnancy to monitor for signs and symptoms of worsening liver disease.

The best way to prevent cirrhosis is to keep your liver healthy. You can do this by eating a healthy diet, engaging in plenty of physical activity, consuming alcohol in moderation (if at all), and reducing your risk of contracting viral hepatitis (e.g., do not share needles or personal hygiene items, do not have unprotected sex.)

During delivery, women with cirrhosis may experience portal hypertension (high blood pressure in the veins leading to the liver), variceal bleeding (hemorrhaging of enlarged blood vessels), and impaired ability of the blood to clot. These complications can usually be managed for pregnant women in the same way they are for non-pregnant people with cirrhosis complications.

If you have cirrhosis and you want to conceive, consult your healthcare provider to maximize your own health and manage your condition first. You will likely undergo a nutritional consultation to assess and monitor for malnutrition and vitamin deficiencies, review your current medications to assess the risks posed to a growing baby, and complete a comprehensive evaluation of your liver function. Some medications used for the treatment of cirrhosis are safe during pregnancy, while others should be avoided. Do not start or stop any medications without talking to your doctor or pharmacist.

Jennifer Gibson
Dr. Jennifer Gibson earned a Bachelor of Science degree in Biochemistry from Clemson University and a Doctor of Pharmacy degree from the Medical College of Virginia School of Pharmacy at Virginia Commonwealth University. She trained as a hospital pharmacist and is the author of clinical textbooks, peer-reviewed journal articles, and continuing education programs for the medical community, as well as a contributor to award-winning healthcare blogs and websites. In her free time, she enjoys running, reading, traveling, and spending time with her family.

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