| Abstract: | The outcome of pregnancy in chronic active hepatitis (CAH) wasstudied retrospectively, together with a survival analysis ofpatients and a comparison of fertility with that expected fromcontrols drawn from the normal Australian population. Clinicalrecords of 73 cases of CAH included 37 women who were potentiallyfertile (aged 15–45 years) and there were 30 pregnanciesamong 16 of these women. Hepatic and obstetric complicationsand the outcome for the foetus and the mother were comparedwith the results from 36 reports accumulated from the literature. The results showed an incremental increase in survival of patientswith CAH according to decade of diagnosis from 1950 and similarseverity of liver disease in those who did, or did not, becomepregnant. Fertility was reduced in patients with CAH. Relapseof CAH occurred during pregnancy in only two patients, hepaticcomplications were minimal, and there was no consistent patternof alteration in liver function; 12 of 16 mothers are alivefor a mean period of eight years after pregnancy. Obstetriccomplications Included urinary tract Infections (six), toxaemiaof pregnancy (nine) and prematurity (seven); of the 30 pregnancies,four were terminated on medical advice in the early years ofthe study, three ended in spontaneous abortion, and there werefour perinatal deaths giving a foetal loss rate of 33 per cent.Despite the maternal disease and use of prednisolone and azathioprineduring pregnancy, the single congenital abnormality was pyloricstenosis. We conclude that in CAH fertility is reduced but pregnancieswhich occur can proceed without detriment to the mother providedthat prednisolone treatment is maintained; that a higher thannormal foetal loss can be expected; and that babies may be bornprematurely but will be normal. |
