A case study of consecutive pregnancies in a woman with liver cirrhosis and portal hypertension

Abstract

Pregnancy in women with liver cirrhosis is a high-risk one that requires multidisciplinary care. Variceal bleeding occurs in up to half of women having associated portal hypertension and confers the greatest risk. Despite advances made in the management of such cases, maternal morbidity remains high. Pregnancy is rare in women with liver cirrhosis due to reduced natural fertility rates. We report a case of two consecutive pregnancies in a woman with liver cirrhosis. A 29-year-old primipara with hepatitis B-related liver cirrhosis with portal hypertension who had been on tenofovir for the past seven years. The first pregnancy was spontaneously conceived but the second was by assisted conception. Both pregnancies were complicated by recurrent episodes of variceal bleeding that necessitated multiple endoscopic variceal band ligation (EVBL) during pregnancy. Medical advancement has enabled women with cirrhosis to have more pregnancies with reduced maternal and perinatal morbidities. Multidisciplinary management is vital to achieving favourable pregnancy outcomes.