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Case Report
Hepatic cirrhosis with portal hypertension secondary to alpha-1 antitrypsin deficiency and autoimmune hepatitis in pregnancy: A case report
1 Junior House Officer, Obstetrics and Gynaecology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
2 Consultant, General Surgery, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
3 Consultant, Obstetric Medicine, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
4 Consultant, Obstetrics and Gynaecology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
Address correspondence to:
Stephanie Galibert
1 Butterfield Street, Herston, QLD 4029,
Australia
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Article ID: 100132Z08SG2022
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How to cite this article
Galibert S, O’Rourke N, Wolski P, Schmidt B. Hepatic cirrhosis with portal hypertension secondary to alpha-1 antitrypsin deficiency and autoimmune hepatitis in pregnancy: A case report. J Case Rep Images Obstet Gynecol 2022;8(2):38–44.ABSTRACT
Introduction: Previously, women with cirrhosis rarely became pregnant due to hypothalamic-pituitary dysfunction. However, with advancements in the care of patients with chronic liver disease, pregnancy is becoming more common in this cohort. We will outline the complex, multidisciplinary approach toward managing an obstetrics patient with portal hypertension in the context of previously decompensated liver cirrhosis.
Case Report: A 29-year-old primigravida woman was referred to the Obstetric Medicine Clinic with an unplanned pregnancy at 16 weeks’ gestation. This was on a background of previously decompensated liver cirrhosis and portal hypertension, in the context of alpha-1 antitrypsin deficiency and autoimmune hepatitis. The patient had one upper gastrointestinal bleed at 19 weeks’ gestation and underwent three gastroscopies throughout her pregnancy. At 32+6 weeks gestation, she had an elective lower uterine segment Caesarean Section and delivered a healthy liveborn female.
Conclusion: Currently, there are no studies that explore pregnancy outcomes in women with cirrhosis secondary to alpha-1 antitrypsin deficiency. This case describes the pregnancy of a woman with previously decompensated liver cirrhosis and portal hypertension, in the context of alpha-1 antitrypsin deficiency and explores the associated management dilemmas.
Keywords: Alpha-1 antitrypsin deficiency, Cirrhosis, Decompensated liver disease, Portal hypertension, Pregnancy
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Author Contributions
Stephanie Galibert - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nicholas O'Rourke - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Penny Wolski - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Bart Schmidt - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Stephanie Galibert et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
