Liver Disease in Pregnancy and Transplant

AbstractPurpose of ReviewThe purpose of this review is to discuss current and new knowledge regarding liver disease in pregnancy and pregnancy post-liver transplantation.Recent FindingsSevere liver disease associated with pregnancy is rare. Liver biopsy is rarely needed for diagnosis but is safe in selected cases. Intrahepatic cholestasis of pregnancy (ICP) with serum bile acids level>  40 μmol/L is associated with adverse fetal outcomes. Ursodeoxycholic acid should be initiated at diagnosis. Portal hypertension can worsen during pregnancy and screening endoscopy should be performed in the 2nd trimester. Maternal hepatitis B antiviral therapy can be considered in the 3rd trime ster if HVB DNA>  200,000 IU/ml. Tacrolimus is the optimal immunosuppressive therapy during pregnancy post-transplantation. Preconception renal function predicts pregnancy outcome. Overall, the outcome of pregnancy post-transplantation is good but there is an increased risk of preterm delivery, low birth weight, hypertension, and pre-eclampsia.SummaryLiver disease of pregnancy can be divided into diseases unique to pregnancy, exacerbated by pregnancy or coexisting with pregnancy. Overall, the outcome of pregnancy post-liver transplantation is good.
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research

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Publication date: Available online 21 September 2019Source: Actas Urológicas Españolas (English Edition)Author(s): O. Yazici, A. Kafkasli, A. Erbin, M. Bilal Hamarat, A. Cubuk, O. Sarilar, K. SaricaAbstractPurposeTo evaluate the effect of JJ stents on SWL treatment of moderate (15–25 mm) renal pelvic stones.Materials and methodsBetween January 2016 and December 2017, a total of 152 adult patients who were planned to undergo SWL for a single radiopaque renal pelvic stone were included in the study. Patients with solitary kidney, congenital abnormality, skeletal tract abnormalities, previous urinary ...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
ConclusionsIrregular width and appearance in ILs were identified successfully with within-section reproducibility. The moderate reproducibility across sections needs to be addressed in further studies by more systematic sampling of sections.SignificanceThe proposed protocol identifies irregularities in a reproducible manner and may suggest that irregular ILs could be used in paleopathology to identify pregnancies and diseases.LimitationsThe correlation between the identified irregular ILs and known pregnancies has not been assessed as part of this study.Suggestions for further researchThe identified irregular ILs need to b...
Source: International Journal of Paleopathology - Category: Pathology Source Type: research
CONCLUSIONS: forty-eight variants were identified in five genes including ABCB4, ABCB11, ATP8B1, SLC4A2 and GPBAR1, twenty-five of which were novel. This study expands the phenotypic and mutational spectrum in genes involved in bile acid homeostasis and highlights the genetic and phenotypic heterogeneity in patients with inherited liver disorders. PMID: 31538484 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
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Source: The Aspergillus Website - updates - Category: Respiratory Medicine Authors: Source Type: news
CONCLUSION: SOF-based DAA regimens are effective and safe in the heterogeneous highly admixed Brazilian population and could remain an option for HCV treatment at least in low-income countries. PMID: 31537509 [PubMed - as supplied by publisher]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
We report the case of a 25-year-old female with cholestatic hepatitis and concomitant intakes of hepatotoxic substances, such as garcinia, field horsetail, and ketoprofen. On suspicion of a drug-induced liver injury, the drugs were promptly withdrawn and ursodeoxycholic acid was started with initial clinical and laboratory improvement, and the patient was discharged from the hospital. One month later, she had a new increase in bilirubin levels and canalicular enzymes, requiring a liver biopsy that showed significant loss of intrahepatic bile ducts, which was compatible with vanishing bile duct syndrome. This was confirmed ...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
ConclusionHigh sensitivity, in particular for the presence of MA, associated with low specificity suggest that PIN and VARS questionnaires can be effective tools to identify those young patients who require specific neurological examinations in view of the prescription of a CHC or pregnancy planning.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Publication date: Available online 21 September 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Gillian A. Ryan, Denis J. Crankshaw, John J. MorrisonAbstractObjectiveThe aim of this study was to compare the effects of oxytocin and ergometrine on the intrinsic contractile parameters of human uterine smooth muscle at term between primiparous and multiparous women.Study DesignMyometrial biopsies were obtained from women undergoing planned caesarean section at term. The biopsies were dissected into eight uniform strips and mounted in tissue baths for isometric recording. The strips...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Publication date: Available online 21 September 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Luis Alonso Pacheco, Antonio Simone Laganà, Simone Garzon, Arantxa Perez Garrido, Alberto Flores Gornes, Fabio GhezziABSTRACTObjectiveTo evaluate the effectiveness of hysteroscopic outpatient metroplasty in women with T-shaped uterus and primary reproductive failure.Study DesignProspective cohort study including nulliparous women with primary unexplained infertility, repeated in vitro fertilization (IVF) failure or recurrent spontaneous miscarriage and T-shaped uterus anomaly ...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Publication date: Available online 21 September 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Misgav Rottenstreich, Khaled Mosmar, Zvi Ehrlich, Ella Kitroser, Sorina Grisaru-Granovsky
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
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