Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-skm99 Total loading time: 0 Render date: 2024-04-27T10:09:14.771Z Has data issue: false hasContentIssue false

Chapter 43 - Gastrointestinal and Liver Diseases in Pregnancy (Content last reviewed: 14th December 2020)

from Section 5 - Late Pregnancy – Maternal Problems

Published online by Cambridge University Press:  15 November 2017

David James
Affiliation:
University of Nottingham
Philip Steer
Affiliation:
Imperial College London
Carl Weiner
Affiliation:
University of Kansas
Bernard Gonik
Affiliation:
Wayne State University, Detroit
Stephen Robson
Affiliation:
University of Newcastle
Get access

Summary

Nausea is one of the most common gastrointestinal symptoms during pregnancy, affecting 50–90% of pregnant women. Independent risk factors for developing nausea during pregnancy include obesity, young maternal age, first pregnancy, and smoking. The pathophysiology of nausea during pregnancy includes alterations in gastric motility, taste, smell, and vestibular function, but psychological factors may also be involved.

Type
Chapter
Information
High-Risk Pregnancy
Management Options
, pp. 1235 - 1271
Publisher: Cambridge University Press
First published in: 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Keller, J, Frederking, D, Layer, P. The spectrum and treatment of gastrointestinal disorders during pregnancy. Nat Clin Pract Gastroenterol Hepatol 2008; 5: 430–43.Google Scholar
Baron, TH, Ramirez, B, Richter, JE. Gastrointestinal motility disorders during pregnancy. Ann Intern Med 1993; 118: 366–75.CrossRefGoogle ScholarPubMed
Goodwin, TM. Nausea and vomiting of pregnancy: an obstetric syndrome. Am J Obstet Gynecol 2002; 186 (5 Suppl): S184–9.Google Scholar
Jarvis, S, Nelson-Piercy, C. Management of nausea and vomiting in pregnancy. BMJ 2011; 342: d3606.CrossRefGoogle ScholarPubMed
Knudsen, A, Lebech, M, Hansen, M. Upper gastrointestinal symptoms in the third trimester of the normal pregnancy. Eur J Obstet Gynecol Reprod Biol 1995; 60: 2933.Google Scholar
Koch, KL. Gastrointestinal factors in nausea and vomiting of pregnancy. Am J Obstet Gynecol 2002; 186 (5 Suppl Understanding): S198–203.CrossRefGoogle ScholarPubMed
Boregowda, G, Shehata, HA. Gastrointestinal and liver disease in pregnancy. Best Pract Res Clin Obstet Gynaecol 2013; 27: 835–53.Google Scholar
Jueckstock, JK, Kaestner, R, Mylonas, I. Managing hyperemesis gravidarum: a multimodal challenge. BMC Med 2010; 8: 46.CrossRefGoogle ScholarPubMed
Trogstad, LI, Stoltenberg, C, Magnus, P, Skjaerven, R, Irgens, LM. Recurrence risk in hyperemesis gravidarum. BJOG 2005; 112: 1641–5.Google Scholar
Dodds, L, Fell, DB, Joseph, KS, Allen, VM, Butler, B. Outcomes of pregnancies complicated by hyperemesis gravidarum. Obstet Gynecol 2006; 107: 285–92.Google Scholar
Tersigni, C, Castellani, R, de Waure, C, et al. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Hum Reprod Update 2014; 20: 582–93.CrossRefGoogle ScholarPubMed
Fiaschi, L, Nelson-Piercy, C, Gibson, J, Szatkowski, L, Tata, LJ. Adverse maternal and birth outcomes in women admitted to hospital for hyperemesis gravidarum: a population-based cohort study. Paediatr Perinat Epidemiol 2018; 32: 4051. doi: 10.1111/ppe.12416.CrossRefGoogle ScholarPubMed
Fossum, S, Naess, Ø, Halvorsen, S, Tell, GS, Vikanes, ÅV. Long-term cardiovascular morbidity following hyperemesis gravidarum: a Norwegian nationwide cohort study. PLoS One 2019; 14 (6): e0218041. doi: 10.1371/journal.pone.0218051.Google Scholar
Kallen, B, Lundberg, G, Aberg, A. Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Acta Obstet Gynecol Scand 2003; 82: 916–20.Google Scholar
Mahadevan, U, Kane, S. American Gastroenterological Association Institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology 2006; 131: 283311.CrossRefGoogle ScholarPubMed
Mahadevan, U, Kane, S. American Gastroenterological Association Institute medical position statement on the use of gastrointestinal medications in pregnancy. Gastroenterology 2006; 131: 278–82.Google Scholar
American College of Obstetrics and Gynecology (ACOG). Practice bulletin: nausea and vomiting of pregnancy. Obstet Gynecol 2004; 103: 803–14.Google Scholar
Arsenault, MY, Lane, CA, MacKinnon, CJ, et al. The management of nausea and vomiting of pregnancy. J Obstet Gynaecol Can 2002; 24: 817–31.Google Scholar
Association of Professors of Gynecology and Obstetrics. Nausea and Vomiting of Pregnancy. APGO Educational Series on Women’s Health Issues. Crofton, MD: APGO, 2011.Google Scholar
Brent, R. Bendectin and birth defects: hopefully, the final chapter. Birth Defects Res A Clin Mol Teratol 2003; 67: 7987.CrossRefGoogle ScholarPubMed
Lamm, SH. The epidemiological assessment of the safety and efficacy of bendectin. In Koren, G, Bishai, R (eds), Nausea and Vomiting of Pregnancy: State of the Art 2000. Toronto: Motherisk, 2000.Google Scholar
Choi, JS, Han, JY, Ahn, K, et al. Fetal outcome after exposure to domperidone during early pregnancy. Birth Defects Res A Clin Mol Teratol. Conference: Teratology Society 49th Annual Meeting Rio Grande Puerto Rico. Conference Publication 2009; 85 (5): 496.Google Scholar
Bottomley, C, Bourne, T. Management strategies for hyperemesis. Pract Res Clin Obstet Gynaecol 2009; 23: 549–64.Google Scholar
Fell, DB, Dodds, L, Joseph, KS, Allen, VM, Butler, B. Risk factors for hyperemesis gravidarum requiring hospital admission during pregnancy. Obstet Gynecol 2006; 107: 277–84.Google Scholar
Gill, SK, Einarson, A. The safety of drugs for the treatment of nausea and vomiting of pregnancy. Expert Opin Drug Saf 2007; 6: 685–94.CrossRefGoogle ScholarPubMed
Matok, I, Gorodischer, R, Koren, G, et al. The safety of metoclopramide use in the first trimester of pregnancy. N Engl J Med 2009; 360: 2528–35.Google Scholar
Mazzotta, P, Magee, LA. A risk-benefit assessment of pharmacological and nonpharmacological treatments for nausea and vomiting of pregnancy. Drugs 2000; 59: 781800.Google Scholar
Einarson, A, Maltepe, C, Navioz, Y, et al. The safety of ondansetron for nausea and vomiting of pregnancy: a prospective comparative study. BJOG 2004; 111: 940–3.Google Scholar
Pasternak, B, Svanstrom, H, Hviid, A. Ondansetron in pregnancy and risk of adverse fetal outcomes. N Engl J Med 2013; 368: 814–23.Google Scholar
Gill, SK, Maltepe, C, Mastali, K, Koren, G. The effect of acid-reducing pharmacotherapy on the severity of nausea and vomiting of pregnancy. Obstet Gynecol Int 2009; 2009: 585269.Google Scholar
Yost, NP, McIntire, DD, Wians, FH, et al. A randomized, placebo-controlled trial of corticosteroids for hyperemesis due to pregnancy. Obstet Gynecol 2003; 102: 1250–4.Google Scholar
Bailit, JL. Hyperemesis gravidarium: epidemiologic findings from a large cohort. Am J Obstet Gynecol 2005; 193: 811–14.Google Scholar
Viljoen, E, Visser, J, Koen, N, Musekiwa, A. A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutr J 2014; 13: 20.Google Scholar
DeVault, KR, Castell, DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1999; 94: 1434–42.Google Scholar
Bassey, OO. Pregnancy heartburn in Nigerians and Caucasians with theories about aetiology based on manometric recordings from the oesophagus and stomach. Br J Obstet Gynaecol 1977; 84: 439–43.Google Scholar
Rey, E, Rodriguez-Artalejo, F, Herraiz, MA, et al. Gastroesophageal reflux symptoms during and after pregnancy: a longitudinal study. Am J Gastroenterol 2007; 102: 2395–400.Google Scholar
Richter, JE. Gastroesophageal reflux disease during pregnancy. Gastroenterol Clin North Am 2003; 32: 235–61.CrossRefGoogle ScholarPubMed
Richter, JE. Review article: the management of heartburn in pregnancy. Aliment Pharmacol Ther 2005; 22: 749–57.Google Scholar
Al-Amri, SM. Twenty-four hour pH monitoring during pregnancy and at postpartum: a preliminary study. Eur J Obstet Gynecol Reprod Biol 2002; 102: 127–30.CrossRefGoogle ScholarPubMed
Ching, CK, Lam, SK. Antacids: indications and limitations. Drugs 1994; 47: 305–17.Google Scholar
Lindow, SW, Regnell, P, Sykes, J, Little, S. An open-label, multicentre study to assess the safety and efficacy of a novel reflux suppressant (Gaviscon Advance) in the treatment of heartburn during pregnancy. Int J Clin Pract 2003; 57: 175–9.CrossRefGoogle ScholarPubMed
Bredenoord, AJ, Pandolfino, JE, Smout, AJ. Gastro-oesophageal reflux disease. Lancet 2013; 381: 1933–42.Google Scholar
Matok, I, Gorodischer, R, Koren, G, et al. The safety of H(2)-blockers use during pregnancy. J Clin Pharmacol 2010; 50: 81–7.Google Scholar
Ruigómez, A, García, Rodríguez LA, Cattaruzzi, C, et al. Use of cimetidine, omeprazole, and ranitidine in pregnant women and pregnancy outcomes. Am J Epidemiol 1999; 150: 476–81.CrossRefGoogle ScholarPubMed
Garbis, H, Elefant, E, Diav-Citrin, O, et al. Pregnancy outcome after exposure to ranitidine and other H2-blockers. A collaborative study of the European Network of Teratology Information Services. Reprod Toxicol 2005; 19: 453–8.Google Scholar
Cappell, MS. The fetal safety and clinical efficacy of gastrointestinal endoscopy during pregnancy. Gastroenterol Clin North Am 2003; 32: 123–79.Google Scholar
Diav-Citrin, O, Arnon, J, Shechtman, S, et al. The safety of proton pump inhibitors in pregnancy: a multicentre prospective controlled study. Aliment Pharmacol Ther 2005; 21: 269–75.Google Scholar
Kallen, BA. Use of omeprazole during pregnancy: no hazard demonstrated in 955 infants exposed during pregnancy. Eur J Obstet Gynecol Reprod Biol 2001; 96: 63–8.Google Scholar
Lalkin, A, Loebstein, R, Addis, A, et al. The safety of omeprazole during pregnancy: a multicenter prospective controlled study. Am J Obstet Gynecol 1998; 179: 727–30.Google Scholar
Pasternak, B, Hviid, A. Use of proton-pump inhibitors in early pregnancy and the risk of birth defects. N Engl J Med 2010; 363: 2114–23.Google Scholar
Astra Zeneca. Prilosec [package insert]. 2012.Google Scholar
Brent, RL. Radiation teratogenesis. Teratology 1980; 21: 281–98.CrossRefGoogle ScholarPubMed
Cappell, MS, Colon, VJ, Sidhom, OA. A study of eight medical centers of the safety and clinical efficacy of esophagogastroduodenoscopy in 83 pregnant females with follow-up of fetal outcome with comparison control groups. Am J Gastroenterol 1996; 91: 348–54.Google Scholar
Moayyedi, P, Bardhan, C, Young, L, et al. Helicobacter pylori eradication does not exacerbate reflux symptoms in gastroesophageal reflux disease. Gastroenterology 2001; 121: 1120–6.Google Scholar
Di Mario, F, Ingegnoli, A, Dal Bo, N, et al. Early epigastric pain after PPI administration: exacerbation of Helicobacter pylori corpus gastritis? Helicobacter 2004; 9: 92–4.Google Scholar
Qian, B, Ma, S, Shang, L, Qian, J, Zhang, G. Effects of Helicobacter pylori eradication on gastroesophageal reflux disease. Helicobacter 2011; 16: 255–65.CrossRefGoogle ScholarPubMed
Malfertheiner, P, Megraud, F, O’Morain, CA, et al. Management of Helicobacter pylori infection: the Maastricht IV/ Florence Consensus Report. Gut 2012; 61: 646–64.CrossRefGoogle ScholarPubMed
Bradley, CS, Kennedy, CM, Turcea, AM, Rao, SS, Nygaard, IE. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110: 1351–7.Google Scholar
Drossman, DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features, and Rome IV. Gastroenterology 2016; 150: 1262–79.e2.CrossRefGoogle Scholar
Vazquez, JC. Constipation, haemorrhoids, and heartburn in pregnancy. BMJ Clin Evid 2008; 2008: 1411.Google Scholar
Trottier, M, Erebara, A, Bozzo, P. Treating constipation during pregnancy. Can Fam Physician 2012; 58: 836–8.Google Scholar
Poskus, T, Buzinskiene, D, Drasutiene, G, et al. Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG 2014; 121: 1666–71.Google Scholar
Ebrahimi, N, Vohra, S, Gedeon, C, et al. The fetal safety of hydrocortisone–pramoxine (Proctofoam-HC) for the treatment of hemorrhoids in late pregnancy. J Obstet Gynaecol Can 2011; 33: 153–8.Google Scholar
Wald, A. Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy. Gastroenterol Clin North Am 2003; 32: 309–22, vii.CrossRefGoogle ScholarPubMed
Girling, JC, Dow, E, Smith, JH. Liver function tests in preeclampsia: importance of comparison with a reference range derived for normal pregnancy. Br J Obstet Gynaecol 1997; 104: 246–50.Google Scholar
David, AL, Kotecha, M, Girling, JC. Factors influencing postnatal liver function tests. BJOG 2000; 107: 1421–6.CrossRefGoogle ScholarPubMed
Hay, JE. Liver disease in pregnancy. Hepatology 2008; 47: 1067–76.CrossRefGoogle ScholarPubMed
Gabzdyl, EM, Schlaeger, JM. Intrahepatic cholestasis of pregnancy: a critical clinical review. J Perinat Neonatal Nurs 2015; 29: 4150.Google Scholar
Gonzalez, MC, Reyes, H, Arrese, M, et al. Intrahepatic cholestasis of pregnancy in twin pregnancies. J Hepatol 1989; 9: 8490.CrossRefGoogle ScholarPubMed
Pan, SG, Li, XW, Jiang, P, et al. Variations of ABCB4 and ABCB11 genes are associated with primary intrahepatic stones. Mol Med Rep 2015; 11: 434–46.Google Scholar
Bacq, Y, Gendrot, C, Perrotin, F, et al. ABCB4 gene mutations and single-nucleotide polymorphisms in women with intrahepatic cholestasis of pregnancy. J Med Genet 2009; 46: 711–15.Google Scholar
Sookoian, S, Castano, G, Burgueno, A, Gianotti, TF, Pirola, CJ. Association of the multidrug-resistance-associated protein gene (ABCC2) variants with intrahepatic cholestasis of pregnancy. J Hepatol 2008; 48: 125–32.Google Scholar
Williamson, C, Geenes, V. Intrahepatic cholestasis of pregnancy. Obstet Gynecol 2014; 124: 120–33.Google Scholar
Reyes, H, Baez, ME, Gonzalez, MC, et al. Selenium, zinc and copper plasma levels in intrahepatic cholestasis of pregnancy, in normal pregnancies and in healthy individuals, in Chile. J Hepatol 2000; 32: 542–9.Google Scholar
Kauppila, A, Korpela, H, Makila, UM, Yrjanheikki, E. Low serum selenium concentration and glutathione-peroxidase activity in intrahepatic cholestasis of pregnancy. Br Med J 1987; 294: 150–2.CrossRefGoogle ScholarPubMed
Royal College of Obstetricians and Gynaecologists. Obstetric Cholestasis, 2nd edn. Green-top Guideline No. 43. London: RCOG, 2011. https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_43.pdf (accessed March 2017).Google Scholar
Glantz, A, Marschall, HW, Mattsson, LA. Intrahepatic cholestasis of pregnancy: Relationships between bile acid levels and fetal complication rates. Hepatology 2004; 40: 467–74.Google Scholar
Campos, GA, Guerra, FA, Israel, EJ. Effects of cholic acid infusion in fetal lambs. Acta Obstet Gynecol Scand 1986; 65: 23–6.Google Scholar
Reid, R, Ivey, KJ, Rencoret, RH, Storey, B. Fetal complications of obstetric cholestasis. Br Med J 1976; 1: 870–2.Google Scholar
Hämäläinen, ST, Turenen, K, Mattila, KJ, Kosunen, E, Sumanen, M. Long-term survival after intrahepatic cholestasis of pregnancy: a follow-up of 571 mothers. Eur J Obstet Gynecol Reprod Biol 2019; 240: 109112. doi: 10.1016/j.ejogrb.2019.06.008.Google Scholar
Ovadia, C, Seed, PT, Sklavounos, A, et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analysis. Lancet 2019; 393: 899909. doi: 10.1016/S0140-6736(18)31877-4.Google Scholar
Savander, M, Ropponen, A, Avela, K, et al. Genetic evidence of heterogeneity in intrahepatic cholestasis of pregnancy. Gut 2003; 52: 1025–9.Google Scholar
Molsa, A, Turunen, K, Mattila, KJ, Sumanen, M. Unnecessary confusion about family planning after intrahepatic cholestasis of pregnancy. Contraception 2012; 86: 639–44.Google Scholar
Food and Drug Administration. [Ursodiol prescribing information.] http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020675s017lbl.pdf (accessed March 2017).Google Scholar
Chappell, LC, Gurung, V, Seed, PT, et al. Ursodeoxycholic acid versus placebo, and early term delivery versus expectant management, in women with intrahepatic cholestasis of pregnancy: semifactorial randomised clinical trial. BMJ 2012; 344: e3799.Google Scholar
Bacq, Y, Sentilhes, L, Reyes, HB, et al. Efficacy of ursodeoxycholic acid in treating intrahepatic cholestasis of pregnancy: a meta-analysis. Gastroenterology 2012; 143: 1492–501.Google Scholar
Grand’Maison, S, Durand, M, Mahone, M. The effects of ursodeoxycholic acid treatment for intrahepatic cholestasis of pregnancy on maternal and fetal outcomes: a meta-analysis including non-randomized studies. J Obstet Gynaecol Can 2014; 36: 632–41.CrossRefGoogle ScholarPubMed
Jiang, ZH, Qiu, ZD, Liu, WW, et al. Intrahepatic cholestasis of pregnancy and its complications: analysis of 100 cases in Chongqing area. Chin Med J (Engl) 1986; 99: 957–60.Google Scholar
Bergasa, NV. The pruritus of cholestasis. Semin Dermatol 1995; 14: 302–12.Google Scholar
Ropponen, A, Sund, R, Riikonen, S, Ylikorkala, O, Aittomaki, K. Intrahepatic cholestasis of pregnancy as an indicator of liver and biliary diseases: a population-based study. Hepatology 2006; 43: 723–8.Google Scholar
Barton, JR, Sibai, BM. Diagnosis and management of hemolysis, elevated liver enzymes, and low platelets syndrome. Clin Perinatol 2004; 31: 807–33, vii.Google Scholar
Weinstein, L. Syndrome of hemolysis, elevated liver-enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am J Obstet Gynecol 1982; 142: 159–67.Google Scholar
Sibai, BM, Taslimi, MM, Elnazer, A, et al. Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver-enzymes, and low platelets in severe preeclampsia-eclampsia. Am J Obstet Gynecol 1986; 155: 501–9.Google Scholar
Sibai, BM. The HELLP syndrome (hemolysis, elevated liver-enzymes, and low platelets): much ado about nothing? Am J Obstet Gynecol 1990; 162: 311–16.CrossRefGoogle ScholarPubMed
Lambert, G, Brichant, JF, Hartstein, G, Bonhomme, V, Dewandre, PY. Preeclampsia: an update. Acta Anaesthesiol Belg 2014; 65: 137–49.Google Scholar
Roberts, JM, August, PA, Bakris, G, et al. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013; 122: 1122–31.Google Scholar
Magann, EF, Bass, D, Chauhan, SP, et al. Antepartum corticosteroids: disease, stabilization in patients with the syndrome of hemolysis, elevated liver-enzymes, and low platelets (HELLP). Am J Obstet Gynecol 1994; 171: 1148–53.Google Scholar
O’Brien, JM, Milligan, DA, Barton, JR. Impact of high-dose corticosteroid therapy for patients with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Am J Obstet Gynecol 2000; 183: 921–4.Google Scholar
Minakami, H, Morikawa, M, Yamada, T, et al. Differentiation of acute fatty liver of pregnancy from syndrome of hemolysis, elevated liver enzymes and low platelet counts. J Obstet Gynaecol Res 2014; 40: 641–9.Google Scholar
Junquera, CG, Balmaseda, E, Gil, E, et al. Acute fatty liver of pregnancy and neonatal long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (LCHAD) deficiency. Eur J Pediatr 2009; 168: 103–6.Google Scholar
Reyes, H. Acute fatty liver of pregnancy. Clin Liver Dis 1999; 3: 6981.Google Scholar
Browning, MF, Levy, HL, Wilkins-Haug, LE, Larson, C, Shih, VE. Fetal fatty acid oxidation defects and maternal liver disease in pregnancy. Obstet Gynecol 2006; 107: 115–20.CrossRefGoogle ScholarPubMed
Homer, L, Hebert, T, Nousbaum, JB, Bacq, Y, Collet, M. How to confirm acute fatty liver of pregnancy in case of emergency? Gynecol Obstet Fertil 2009; 37: 246–51.Google Scholar
Wu, Z, Huang, P, Gong, Y, Wan, J, Zou, W. Treating acute fatty liver of pregnancy with artificial liver support therapy. Medicine (Baltimore) 2018; 97: e12473. doi: 10.1097/MD.0000000000012473.Google Scholar
Tein, I. Metabolic disease in the fetus predisposes to maternal hepatic complications of pregnancy. Pediatr Res 2000; 47: 68.Google Scholar
Fair, J, Klein, AS, Feng, T, Merritt, WT, Burdick, JF. Intrapartum orthotopic liver transplantation with successful outcome of pregnancy. Transplantation 1990; 50: 534–5.Google Scholar
Hamilton, MI, Alcock, R, Magos, L, et al. Liver transplantation during pregnancy. Transplant Proc 1993; 25: 2967–8.Google Scholar
Westbrook, RH, Yeoman, AD, Joshi, D, et al. Outcomes of severe pregnancy-related liver disease: refining the role of transplantation. Am J Transplant 2010; 10: 2520–6.Google Scholar
Khashan, AS, Quigley, EM, McNamee, R, et al. Increased risk of miscarriage and ectopic pregnancy among women with irritable bowel syndrome. Clin Gastroenterol Hepatol 2012; 10: 902–9.Google Scholar
Brandt, LJ, Chey, WD, Foxx-Orenstein, AE, et al. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol 2009; 104 (Suppl 1): S1–35.Google Scholar
Hasler, WL. The irritable bowel syndrome during pregnancy. Gastroenterol Clin North Am 2003; 32: 385406, viii.Google Scholar
Wen, SW, Walker, M. Risk of fetal exposure to tricyclic antidepressants. J Obstet Gynaecol Can 2004; 26: 887–92.Google Scholar
van der Woude, CJ, Metselaar, HJ, Danese, S. Management of gastrointestinal and liver diseases during pregnancy. Gut 2014; 63: 1014–23.Google Scholar
Myles, N, Newall, H, Ward, H, Large, M. Systematic meta-analysis of individual selective serotonin reuptake inhibitor medications and congenital malformations. Aust N Z J Psychiatry 2013; 47: 1002–12.Google Scholar
Stephansson, O, Kieler, H, Haglund, B, et al. Selective serotonin reuptake inhibitors during pregnancy and risk of stillbirth and infant mortality. JAMA 2013; 309: 4854.Google Scholar
Goa, SY, Wu, QJ, Zhang, TN, et al. Selective serotonin reuptake inhibitor use during early pregnancy and congenital malformations: a systematic review and meta-analysis of cohort studies of more than 9 million births. BMC Med 2018; 16: 205. doi: 10.1186/s12916-018-1193-5.Google Scholar
Brown, HK, Hussain-Shamsy, N, Lunsky, Y, Dennis, CE, Vigod, SN. The association between antenatal exposure to selective serotonin reuptake inhibitors and autism: a systematic review and meta-analysis. J Clin Psychiatry 2017; 78 (1): e4858. doi: 10.4088/JCP.15r10194.Google Scholar
Einarson, A, Mastroiacovo, P, Arnon, J, et al. Prospective, controlled, multicentre study of loperamide in pregnancy. Can J Gastroenterol 2000; 14: 185–7.Google Scholar
Kallen, B, Nilsson, E, Otterblad, Olausson P. Maternal use of loperamide in early pregnancy and delivery outcome. Acta Paediatr 2008; 97: 541–5.Google Scholar
Schwethelm, B, Margolis, LH, Miller, C, Smith, S. Risk status and pregnancy outcome among medicaid recipients. Am J Prev Med 1989; 5: 157–63.Google Scholar
Nardulli, G, Limongi, F, Sue, G, Zapata, L, Bompart, I. [Use of polyethylene glycol in the treatment of puerperal constipation]. G E N 1995; 49: 224–6.Google Scholar
Cornish, J, Tan, E, Teare, J, et al. A meta-analysis on the influence of inflammatory bowel disease on pregnancy. Gut 2007; 56: 830–7.Google Scholar
Dominitz, JA, Young, JC, Boyko, EJ. Outcomes of infants born to mothers with inflammatory bowel disease: a population-based cohort study. Am J Gastroenterol 2002; 97: 641–8.Google Scholar
Fonager, K, Sorensen, HT, Olsen, J, Dahlerup, JF, Rasmussen, SN. Pregnancy outcome for women with Crohn’s disease: a follow-up study based on linkage between national registries. Am J Gastroenterol 1998; 93: 2426–30.Google Scholar
Kornfeld, D, Cnattingius, S, Ekbom, A. Pregnancy outcomes in women with inflammatory bowel disease: a population-based cohort study. Am J Obstet Gynecol 1997; 177: 942–6.Google Scholar
Pedersen, N, Bortoli, A, Duricova, D, et al. The course of inflammatory bowel disease during pregnancy and postpartum: a prospective European ECCO-EpiCom Study of 209 pregnant women. Aliment Pharmacol Ther 2013; 38: 501–12.Google Scholar
Nielsen, OH, Andreasson, B, Bondesen, S, Jacobsen, O, Jarnum, S. Pregnancy in Crohn’s disease. Scand J Gastroenterol 1984; 19: 724–32.Google Scholar
Norgard, B, Hundborg, HH, Jacobsen, BA, Nielsen, GL, Fonager, K. Disease activity in pregnant women with Crohn’s disease and birth outcomes: a regional Danish cohort study. Am J Gastroenterol 2007; 102: 1947–54.Google ScholarPubMed
Reddy, D, Murphy, SJ, Kane, SV, Present, DH, Kornbluth, AA. Relapses of inflammatory bowel disease during pregnancy: in-hospital management and birth outcomes. Am J Gastroenterol 2008; 103: 1203–9.Google Scholar
Broms, G, Granath, F, Linder, M, et al. Complications from inflammatory bowel disease during pregnancy and delivery. Clinical Gastroenterol Hepatol 2012; 10: 1246–52.Google Scholar
Hanan, IM. Inflammatory bowel disease in the pregnant woman. Compr Ther 1998; 24: 409–14.Google Scholar
Nielsen, OH, Andreasson, B, Bondesen, S, Jarnum, S. Pregnancy in ulcerative colitis. Scand J Gastroenterol 1983; 18: 735–42.Google Scholar
van der Woude, CJ, Kolacek, S, Dotan, I, et al. European evidenced-based consensus on reproduction in inflammatory bowel disease. J Crohns Colitis 2010; 4: 493510.Google Scholar
De Lima, A, Zelinkova, Z, Mulders, AGMGJ, van der Woude, CJ. Preconception care reduces relapse of inflammatory bowel disease during pregnancy. Clin Gastroenterol Hepatol 2016; 14: 1285–92.e1. doi: 10.1016/j.cgh.2016.03.018.Google Scholar
Hernandez-Diaz, S, Su, YC, Mitchell, AA, et al. Medications as a potential source of exposure to phthalates among women of childbearing age. Reprod Toxicol 2013; 37: 15.Google Scholar
Jurewicz, J, Hanke, W. Exposure to phthalates: reproductive outcome and children health. Int J Occup Med Environ Health 2011; 24: 115–41.Google Scholar
Norgard, B, Czeizel, AE, Rockenbauer, M, Olsen, J, Sorensen, HT. Population-based case control study of the safety of sulfasalazine use during pregnancy. Aliment Pharmacol Ther 2001; 15: 483–6.Google Scholar
Rahimi, R, Nikfar, S, Rezaie, A, Abdollahi, M. Pregnancy outcome in women with inflammatory bowel disease following exposure to 5-aminosalicylic acid drugs: a meta-analysis. Reprod Toxicol 2008; 25: 271–5.Google Scholar
Park-Wyllie, L, Mazzotta, P, Pastuszak, A, et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology 2000; 62: 385–92.Google Scholar
Hviid, A, Molgaard-Nielsen, D. Corticosteroid use during pregnancy and risk of orofacial clefts. CMAJ 2011; 183: 796804.Google Scholar
Homar, V, Grosek, S, Battelino, T. High-dose methylprednisolone in a pregnant woman with Crohn’s disease and adrenal suppression in her newborn. Neonatology 2008; 94: 306–9.Google Scholar
van Runnard Heimel, PJ, Franx, A, Schobben, AF, et al. Corticosteroids, pregnancy, and HELLP syndrome: a review. Obstet Gynecol Surv 2005; 60: 5770.Google Scholar
van Runnard, Heimel PJ, Schobben, AF, Huisjes, AJ, Franx, A, Bruinse, HW. The transplacental passage of prednisolone in pregnancies complicated by early-onset HELLP syndrome. Placenta 2005; 26: 842–5.Google Scholar
Beaulieu, DB, Ananthakrishnan, AN, Issa, M, et al. Budesonide induction and maintenance therapy for Crohn’s disease during pregnancy. Inflamm Bowel Dis 2009; 15: 25–8.CrossRefGoogle ScholarPubMed
Jharap, B, de Boer, NK, Stokkers, P, et al. Intrauterine exposure and pharmacology of conventional thiopurine therapy in pregnant patients with inflammatory bowel disease. Gut 2014; 63: 451–7.Google Scholar
de Boer, NK, Van Elburg, RM, Wilhelm, AJ, et al. 6-Thioguanine for Crohn’s disease during pregnancy: thiopurine metabolite measurements in both mother and child. Scand J Gastroenterol 2005; 40: 1374–7.Google Scholar
Angelberger, S, Reinisch, W, Messerschmidt, A, et al. Long-term follow-up of babies exposed to azathioprine in utero and via breastfeeding. J Crohns Colitis 2011; 5: 95100.Google Scholar
Casanova, MJ, Chaparro, M, Domenech, E, et al. Safety of thiopurines and anti-TNF-alpha drugs during pregnancy in patients with inflammatory bowel disease. Am J Gastroenterol 2013; 108: 433–40.Google Scholar
Coelho, J, Beaugerie, L, Colombel, JF, et al. Pregnancy outcome in patients with inflammatory bowel disease treated with thiopurines: cohort from the CESAME Study. Gut 2011; 60: 198203.Google Scholar
Hutson, JR, Matlow, JN, Moretti, ME, Koren, G. The fetal safety of thiopurines for the treatment of inflammatory bowel disease in pregnancy. J Obstet Gynaecol 2013; 33: 18.Google Scholar
Shim, L, Eslick, GD, Simring, AA, Murray, H, Weltman, MD. The effects of azathioprine on birth outcomes in women with inflammatory bowel disease (IBD). J Crohns Colitis 2011; 5: 234–8.Google Scholar
Akbari, M, Shah, S, Velayos, FS, Mahadevan, U, Cheifetz, AS. Systematic review and meta-analysis on the effects of thiopurines on birth outcomes from female and male patients with inflammatory bowel disease. Inflamm Bowel Dis 2013; 19: 1522.Google Scholar
Kanis, SL, de Lima-Karagiannis, A, de Boer, NK, van der Woude, CJ. Use of thiopurines during conception and pregnancy not associated with adverse pregnancy outcomes or health of infants at 1 year in a prospective study. Clin Gastroenterol Hepatol 2017; S1542-3565(17): 30319–1.Google Scholar
Kozlowski, RD, Steinbrunner, JV, MacKenzie, AH, et al. Outcome of first-trimester exposure to low-dose methotrexate in eight patients with rheumatic disease. Am J Med 1990; 88: 589–92.Google Scholar
Smithells, RW, Newman, CG. Recognition of thalidomide defects. J Med Genet 1992; 29: 716–23.Google Scholar
Bar Oz, B, Hackman, R, Einarson, T, Koren, G. Pregnancy outcome after cyclosporine therapy during pregnancy: a meta-analysis. Transplantation 2001; 71: 1051–5.Google Scholar
Branche, J, Cortot, A, Bourreille, A, et al. Cyclosporine treatment of steroid-refractory ulcerative colitis during pregnancy. Inflamm Bowel Dis 2009; 15: 1044–8.Google Scholar
Mahadevan, U, Wolf, DC, Dubinsky, M, et al. Placental transfer of anti-tumor necrosis factor agents in pregnant patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2013; 11: 286–92.Google Scholar
Zelinkova, Z, van der Ent, C, Bruin, KF, et al. Effects of discontinuing anti-tumor necrosis factor therapy during pregnancy on the course of inflammatory bowel disease and neonatal exposure. Clin Gastroenterol Hepatol 2013; 11: 318–21.Google Scholar
Marchioni, RM, Lichtenstein, GR. Tumor necrosis factor-alpha inhibitor therapy and fetal risk: a systematic literature review. World J Gastroenterol 2013; 19: 2591–602.Google Scholar
Schnitzler, F, Fidder, H, Ferrante, M, et al. Outcome of pregnancy in women with inflammatory bowel disease treated with antitumor necrosis factor therapy. Inflamm Bowel Dis 2011; 17: 1846–54.Google Scholar
Mahadevan, U, Martin, CF, Sandler, RS, et al. PIANO: a 1000 patient prospective registry of pregnancy outcomes in women with IBD exposed to immunomodulators and biologic therapy. Gastroenterology 2012; 142(5 Suppl 1): S-149.Google Scholar
Nielsen, OH, Loftus, EV, Jess, T. Safety of TNF-α inhibitors during IBD pregnancy: a systematic review. BMC Med 2013; 11: 174.Google Scholar
Kanis, SL, de Lima-Karagiannis, A, van der Ent, C, Rizopoulos, D, van der Woude, CJ. Anti-TNF levels in cord blood at birth are associated with anti-TNF type. J Crohns Colitis 2018; 12: 939–47. doi: 10.1093/ecco-jcc/jjy058.Google Scholar
de Lima, A, Zelinkova, Z, van der Ent, C, Steegers, EA, van der Woude, CJ. Tailored anti-TNF therapy during pregnancy in patients with IBD: maternal and fetal safety. Gut 2016; 65: 1261–8.Google Scholar
Moens, A, van Hoeve, K, Humblet, E, et al. Outcome of pregnancies in female patients with inflammatory bowel diseases treated with vedolizumab. J Crohns Colitis 2019; 13: 1218. doi: 10.1093/ecco-jcc/jjy142.Google Scholar
Bar-Gil Shitrit, A, Ben Ya’acov, A, Livovsky, DM. Exposure to vedolizumab in IBD pregnant women appears of low risk for mother and neonate: a first prospective comparison study. Am J Gastroenterol 2019; 114: 1172–5. doi: 10.14309/ajg.0000000000000186.Google Scholar
Moens, A, van der Woude, CJ, Julsgaard, M, et al. Pregnancy outcomes in inflammatory bowel disease patients treated with vedolizumab, anti-TNF or conventional therapy: results of the European CONCEIVE study. Aliment Pharmacol Ther 2020; 51: 129–38. https://doi.org/10.1111/apt.15539.Google Scholar
Klenske, E, Osaba, L, Nagore, D, et al. Drug levels in the maternal serum, cord blood and breast milk of a ustekinumab-treated patient with Crohn's disease. J Crohns Colitis 2019; 13: 267–9. doi: 10.1093/ecco-jcc/jjy153.Google Scholar
Rowan, CR, Cullen, G, Mulcahy, HE, et al. Ustekinumab drug levels in maternal and cord blood in a woman with Crohn–s disease treated until 33 weeks of gestation. J Crohns Colitis 2018; 12: 376–8. doi: 10.1093/ecco-jcc/jjx141.Google Scholar
Venturin, C, Nancey, S, Danoin, P, et al. Fetal death in utero and miscarriage in a patient with Crohn's disease under therapy with ustekinumab: case-report and review of the literature. BMC Gastroenterol 2017; 17: 80. doi: 10.1186/s12876-017-0633-6.Google Scholar
Cortes, X, Borras-Blasco, J, Antequera, B, et al. Ustekinumab therapy for Crohn's disease during pregnancy: a case report and review of the literature. J Clin Pharm Ther 2017; 42: 234–6. doi: 10.1111/jcpt.12492.Google Scholar
Tofacitinib: prescribing information [Internet]. www.accessdata.fda.gov/drugsatfda_docs/label/2018/203214s018lbl.pdf (accessed September 2019).Google Scholar
Mahadevan, U, Dubinsky, MC, Chinyu, S, et al. Outcomes of pregnancies with maternal/paternal exposure in the tofacitinib safety databases for ulcerative colitis. Inflamm Bowel Dis 2018; 24: 2494–500. doi: 10.1093/ibd/izy160.Google Scholar
Koss, CA, Baras, DC, Lane, SD, et al. Investigation of metronidazole use during pregnancy and adverse birth outcomes. Antimicrob Agents Chemother 2012; 56: 4800–5.Google Scholar
Berkovitch, M, Pastuszak, A, Gazarian, M, Lewis, M, Koren, G. Safety of the new quinolones in pregnancy. Obstet Gynecol 1994; 84: 535–8.Google Scholar
Linseman, DA, Hampton, LA, Branstetter, DG. Quinolone-induced arthropathy in the neonatal mouse. Morphological analysis of articular lesions produced by pipemidic acid and ciprofloxacin. Fundam Appl Toxicol 1995; 28: 5964.Google Scholar
Hill, J, Treasure, T, Guideline Development Group. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital: summary of the NICE guideline. Heart 2010; 96: 879–82.Google Scholar
Van Assche, G, Dignass, A, Reinisch, W, et al. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: special situations. J Crohns Colitis 2010; 4: 63101.Google Scholar
Chen, YH, Lin, HC, Lou, HY. Increased risk of low birthweight, infants small for gestational age, and preterm delivery for women with peptic ulcer. Am J Obstet Gynecol 2010; 202: 164 e1–8.Google Scholar
Cappell, MS, Sidhom, O. A multicenter, multiyear study of the safety and clinical utility of esophagogastroduodenoscopy in 20 consecutive pregnant females with follow-up of fetal outcome. Am J Gastroenterol 1993; 88: 1900–5.Google Scholar
Cappell, MS. Risks versus benefits of gastrointestinal endoscopy during pregnancy. Nat Rev Gastroenterol Hepatol 2011; 8: 610–34.Google Scholar
Institute of Medicine Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy. Washington, DC: National Academies Press, 1990.Google Scholar
Atherton, JC. H. pylori virulence factors. Br Med Bull 1998; 54: 105–20.Google Scholar
Chey, WD, Wong, BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol 2007; 102: 1808–25.Google Scholar
James, LF, Lazar, VA, Binns, W. Effects of sublethal doses of certain minerals on pregnant ewes and fetal development. Am J Vet Res 1966; 27: 132–5.Google Scholar
Lione, A. Nonprescription drugs as a source of aluminum, bismuth, and iodine during pregnancy. Reprod Toxicol 1987; 1: 243–52.Google Scholar
Whalley, PJ, Adams, RH, Combes, B. Tetracycline toxicity in pregnancy. liver and pancreatic dysfunction. JAMA 1964; 189: 357–62.Google Scholar
West, J. Coeliac disease: studies of its frequency and consequence. PhD thesis, University of Nottingham, 2005.Google Scholar
Rashtak, S, Murray, JA. Review article: coeliac disease, new approaches to therapy. Aliment Pharm Ther 2012; 35: 768–81.Google Scholar
Green, PH, Jabri, B. Coeliac disease. Lancet 2003; 362: 383–91.Google Scholar
Sultan, AA, Tata, LJ, Fleming, KM, et al. Pregnancy complications and adverse birth outcomes among women with celiac disease: a population-based study from England. Am J Gastroenterol 2014; 109: 1653–61.Google Scholar
Greco, L, Veneziano, A, Di Donato, L et al. Undiagnosed coeliac disease does not appear to be associated with unfavourable outcome of pregnancy. Gut 2004; 53: 149–51.Google Scholar
Ludvigsson, JF, Montgomery, SM, Ekbom, A. Celiac disease and risk of adverse fetal outcome: a population-based cohort study. Gastroenterology 2005; 129: 454–63.Google Scholar
Meloni, GF, Dessole, S, Vargiu, N, Tomasi, PA, Musumeci, S. The prevalence of coeliac disease in infertility. Hum Reprod 1999; 14: 2759–61.Google Scholar
Kolho, KL, Tiitinen, A, Tulppala, M, Unkila-Kallio, L, Savilahti, E. Screening for coeliac disease in women with a history of recurrent miscarriage or infertility. Br J Obstet Gynaecol 1999; 106: 171–3.Google Scholar
Tata, LJ, Card, TR, Logan, RF, et al. Fertility and pregnancy-related events in women with celiac disease: a population-based cohort study. Gastroenterology 2005; 128: 849–55.Google Scholar
Sungler, P, Heinerman, PM, Steiner, H, et al.. Laparoscopic cholecystectomy and interventional endoscopy for gallstone complications during pregnancy. Surg Endosc 2000; 14: 267–71.Google Scholar
Ko, CW, Beresford, SA, Schulte, SJ, Matsumoto, AM, Lee, SP. Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy. Hepatology 2005; 41: 359–65.Google Scholar
Al-Hashem, H, Muralidharan, V, Cohen, H, Jamidar, PA. Biliary disease in pregnancy with an emphasis on the role of ERCP. J Clin Gastroenterol 2009; 43: 5862.Google Scholar
Van Bodegraven, AA, Bohmer, CJ, Manoliu, RA, et al. Gallbladder contents and fasting gallbladder volumes during and after pregnancy. Scand J Gastroenterol 1998; 33: 993–7.Google Scholar
Ramin, KD, Ramsey, PS. Disease of the gallbladder and pancreas in pregnancy. Obstet Gynecol Clin North Am 2001; 28: 571–80.Google Scholar
McKellar, DP, Anderson, CT, Boynton, CJ, Peoples, JB. Cholecystectomy during pregnancy without fetal loss. Surg Gynecol Obstet 1992; 174: 465–8.Google Scholar
Axelrad, AM, Fleischer, DE, Strack, LL, Benjamin, SB, al-Kawas, FH. Performance of ERCP for symptomatic choledocholithiasis during pregnancy: techniques to increase safety and improve patient management. Am J Gastroenterol 1994; 89: 109–12.Google Scholar
Shelton, J, Linder, JD, Rivera-Alsina, ME, Tarnasky, PR. Commitment, confirmation, and clearance: new techniques for nonradiation ERCP during pregnancy (with videos). Gastrointest Endosc 2008; 67: 364–8.Google Scholar
Tang, SJ, Mayo, MJ, Rodriguez-Frias, E, et al. Safety and utility of ERCP during pregnancy. Gastrointest Endosc 2009; 69: 453–61.Google Scholar
Manns, MP, Czaja, AJ, Gorham, JD, et al. Diagnosis and management of autoimmune hepatitis. Hepatology 2010; 51: 2193–213.Google Scholar
Schramm, C, Herkel, J, Beuers, U, et al. Pregnancy in autoimmune hepatitis: outcome and risk factors. Am J Gastroenterol 2006; 101: 556–60.Google Scholar
Heneghan, MA, Norris, SM, O’Grady, JG, Harrison, PM, McFarlane, IG. Management and outcome of pregnancy in autoimmune hepatitis. Gut 2001; 48: 97102.Google Scholar
Gronbaek, L, Vilstrup, H, Jepsen, P. Pregnancy and birth outcomes in a Danish nationwide cohort of women with autoimmune hepatitis and matched population controls. Aliment Pharmacol Ther 2018; 48: 655–63. doi: 10.1111/apt.14925.Google Scholar
Anderka, MT, Lin, AE, Abuelo, DN, Mitchell, AA, Rasmussen, SA. Reviewing the evidence for mycophenolate mofetil as a new teratogen: case report and review of the literature. Am J Med Genet A 2009; 149A: 1241–8.CrossRefGoogle ScholarPubMed
Talwalkar, JA, Lindor, KD. Primary biliary cirrhosis. Lancet 2003; 362: 5361.Google Scholar
Boonstra, K, Bokelaar, R, Stadhouders, PH, et al. Increased cancer risk in a large population-based cohort of patients with primary biliary cirrhosis: follow-up for up to 36 years. Hepatol Int 2014; 8: 266–74.Google Scholar
Ahrens, EH, Payne, MA, Kunkel, HG, Eisenmenger, WJ, Blondheim, SH. Primary biliary cirrhosis. Medicine (Baltimore) 1950; 29: 299364.Google Scholar
Whelton, MJ, Sherlock, S. Pregnancy in patients with hepatic cirrhosis management and outcome. Lancet 1968; 2: 995–9.Google Scholar
Mack, HC, Segar, LF, Robinson, AR, Wiseman, ME, Moyer, EZ Electrophoretic patterns of plasma proteins in pregnancy II. Pregnancy complicated by liver disease. Obstet Gynecol 1953; 204: 204–11.Google Scholar
Nir, A, Sorokin, Y, Abramovici, H, Theodor, E. Pregnancy and primary biliary-cirrhosis. Int J Gynaecol Obstet 1989; 28: 279–82.Google Scholar
Wong, KK, Goh, KL. Pregnancy in primary biliary cirrhosis. Eur J Obstet Gynecol Reprod Biol 1992; 45: 149–51.Google Scholar
Olsson, R, Loof, L, Wallerstedt, S. Pregnancy in patients with primary biliary cirrhosis: a case for dissuasion? Liver 1993; 13: 316–18.Google Scholar
Ji, HX, Haring, P, Kirkinen, P, Saarikoski, S. Glucocorticoid treatment of primary biliary cirrhosis in a pregnant woman. Acta Obstet Gynecol Scand 1995; 74: 654–6.Google Scholar
Rabinovitz, M, Appasamy, R, Finkelstein, S. Primary biliary cirrhosis diagnosed during pregnancy: does it have a different outcome? Digest Dis Sci 1995; 40: 571–4.Google Scholar
Rudi, J, Schonig, T, Stremmel, W. Treatment with ursodeoxycholic acid in primary biliary cirrhosis during pregnancy. Z Gastroenterol 1996; 34: 188–91.Google Scholar
Goh, SK, Gull, SE, Alexander, GJ. Pregnancy in primary biliary cirrhosis complicated by portal hypertension: report of a case and review of the literature. BJOG 2001; 108: 760–2.Google Scholar
Allen, AM, Hay, JE. Review article: the management of cirrhosis in women. Aliment Pharm Ther 2014; 40: 1146–54.Google Scholar
Ducarme, G, Bernuau, J, Luton, D. [Primary biliary cirrhosis and pregnancy]. J Gynecol Obstet Biol Reprod (Paris) 2014; 43: 335–41.Google Scholar
Ali, AH, Carey, EJ, Lindor, KD. Diagnosis and management of primary biliary cirrhosis. Expert Rev Clin Immunol 2014; 10: 1667–78.Google Scholar
Heidelbaugh, JJ, Bruderly, M. Cirrhosis and chronic liver failure: part I. Diagnosis and evaluation. Am Fam Physician 2006; 74: 756–62.Google Scholar
Russell, MA, Craigo, SD. Cirrhosis and portal hypertension in pregnancy. Seminars in perinatology 1998; 22: 156–65.Google Scholar
Benjaminov, FS, Heathcote, J. Liver disease in pregnancy. Am J Gastroenterol 2004; 99: 2479–88.Google Scholar
Hagstrom, H, Hoijer, J, Marschall, HU, et al. Outcomes of pregnancy in mothers with cirrhosis: a national population-based cohort study of 1.3 million pregnancies. Hepatol Commun 2018; 2: 1299–305. doi: 10.1002/hep4.1255.Google Scholar
Tan, J, Surti, B, Saab, S. Pregnancy and cirrhosis. Liver Transpl 2008; 14: 1081–91.Google Scholar
Sumana, G, Dadhwal, V, Deka, D, Mittal, S. Non-cirrhotic portal hypertension and pregnancy outcome. J Obstet Gynaecol Res 2008; 34: 801–4.Google Scholar
Cappell, MS. Hepatic disorders mildly to moderately affected by pregnancy: medical and obstetric management. Med Clin North Am 2008; 92: 717–37, vii.Google Scholar
Blachier, M, Leleu, H, Peck-Radosavljevic, M, Valla, DC, Roudot-Thoraval, F. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol 2013; 58: 593608.Google Scholar
Deshpande, NA, James, NT, Kucirka, LM, et al. Pregnancy outcomes of liver transplant recipients: a systematic review and meta-analysis. Liver Transpl 2012; 18: 621–9.Google Scholar
Walcott, WO, Derick, DE, Jolley, JJ, Snyder, DL, Schmid, R. Successful pregnancy in a liver transplant patient. Am J Obstet Gynecol 1978; 132: 340–1.Google Scholar
Ramirez, CB, Doria, C. Pregnancy after liver transplantation. Best Pract Res Clin Obstet Gynaecol 2014; 28: 1137–45.Google Scholar
Cyganek, A, Pietrzak, B, Kociszewska-Najman, B, et al. Intrauterine growth restriction in pregnant renal and liver transplant recipients: risk factors assessment. Transplant Proc 2014; 46: 2794–7.Google Scholar
Prodromidou, A, kostakis, ID, Machairas, N, et al. Pregnancy outcomes after liver transplantation. Transplant Proc 2019, 51, 446–9. doi: 10.1016/j.transproceed.2019.01.014.Google Scholar
Deshpande, NA, James, NT, Kucirka, LM, et al. Pregnancy outcomes of liver transplant recipients: a systematic review and meta-analysis. Liver Transpl 2012; 18: 621–9. doi: 10.1002/lt.23416.Google Scholar
Blume, C, Pischke, S, von Versen-Hoynck, F, Gunter, HH, Gross, MM. Pregnancies in liver and kidney transplant recipients: a review of the current literature and recommendation. Best Pract Res Clin Obstet Gynaecol 2014; 28: 1123–36.Google Scholar
Kamarajah, SK, Arntdz, K, Bundred, J, et al. Outcomes of pregnancy in recipients of liver transplants. Clin Gastroenterol Hepatol 2019; 17: 1398–1404.e1. doi: 10.1016/j.cgh.2018.11.055.Google Scholar
Zaffar, N, Soete, E, Gandhi, S, et al. Pregnancy outcomes following single and repeat liver transplantation: an international two-centre cohort. Liver Transpl 2018; 24: 769–78. doi: 10.1002/lt.25071.Google Scholar
Christopher, V, Al-Chalabi, T, Richardson, PD, et al. Pregnancy outcome after liver transplantation: a single-center experience of 71 pregnancies in 45 recipients. Liver Transpl 2006; 12: 1138–43.Google Scholar
Sifontis, NM, Coscia, LA, Nguyen, TD, et al. Pregnancy outcomes with exposure to mycophenolic acid products. Am J Transplant 2010; 10 (S4): 169–70.Google Scholar
Joshi, D, James, A, Quaglia, A, Westbrook, RH, Heneghan, MA. Liver disease in pregnancy. Lancet 2010; 375: 594605.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×