Clin Gastroenterol H:肝移植患者的妊娠结局

2018-12-11 xing.T MedSci原创

由此可见,在肝移植后怀孕的女性中,几乎70%都是活产,尽管这一比例低于整体人群的比例。这些病例需要肝病专家和产科医生的共同参与。

尽管接受肝脏移植的妇女怀孕的报道越来越多,但尚不清楚移植和免疫抑制如何影响怀孕。近日,消化病领域权威杂志Clinical Gastroenterology and Hepatology发表了一篇研究文章,研究人员收集了怀孕的肝移植患者免疫抑制方案、妊娠管理、移植物发病以及孕妇和新生儿结局等数据。

研究人员检索了英国伯明翰的肝脏移植数据库,收集了1986年8月至2016年5月期间肝移植后报告了怀孕的妇女的数据。研究人员收集了83名妇女139次妊娠期间疾病和结局信息(受孕年龄中位数为27岁;范围为15-46岁)。Fisher精确检验用于比较分类变量,Mann-Whitney U和Kruskal-Wallis检验用于比较连续变量。主要结局是整个队列中的活产率。分析的其他结局包括免疫治疗方案的差异,暴露于环孢菌素和他克莫司相关的结局、移植时间(短于 vs.长于12个月以上)和妊娠时间(1986-2000 vs. 2001-2016)。

对于139次妊娠,69%活产,19%流产或死胎,9%终止妊娠。在肝移植后超过1年后怀孕的患者中,活产的比例高于在此之前怀孕的女性(98% vs. 80%,P=0.006)。与环孢菌素暴露相比,他克莫司暴露与早产(P=0.045)和剖腹产(P=0.031)的风险相关。与1986 - 2000年期间相比,在2001-2016年期间怀孕的女性移植与受孕之间的时间明显缩短(中位数为3年 vs. 7年,P=0.027),使用他克莫司比环孢菌素更频繁(84% vs. 26%,P=0.001),剖宫产率更高(44% vs. 32%,P=0.025)。

由此可见,在肝移植后怀孕的女性中,几乎70%都是活产,尽管这一比例低于整体人群的比例。这些病例需要肝病专家和产科医生的共同参与。

原始出处:

Sivesh K. Kamarajah,et al.Outcomes of Pregnancy in Recipients of Liver Transplants. Clinical gastroenterology and hepatology.2018.https://www.cghjournal.org/article/S1542-3565(18)31332-6/fulltext

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    2019-06-02 许安
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    2018-12-12 1dd8a7c5m95(暂无匿称)

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

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    2018-12-12 yjs木玉

    好好好好好好好好

    0

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