Pregnancy in Primary Sclerosing Cholangitis

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Presentation transcript:

Pregnancy in Primary Sclerosing Cholangitis

Medical Conditions During Pregnancy What is the effect of the pregnancy on the medical condition (risks to the mother) What is the effect of the medical condition on the pregnancy (pregnancy outcomes, risk for baby)

Preconception Counseling Important to plan pregnancy Discuss use of medications Include maternal-fetal medicine specialist Optimize health prior to becoming pregnant

Medical Literature Limited information from case reports or small case series Largest study, 229 pregnancies in mothers with PSC, from Sweden Approximately 1/3 of women also had inflammatory bowel disease (either Crohn’s disease or ulcerative colitis)

Outcomes Increased risk for preterm delivery Increased risk for LGA (large for gestational age) babies Increased risk for c-section

Outcomes No increased risk for birth defects No increased risk for stillbirths No major maternal complications

Medications Ursodeoxycholic acid and azathioprine are considered to be safe if needed in pregnancy and are used in other medical conditions

Fertility Does not seem to be decreased compared to women without PSC Cirrhosis does have a negative impact on fertility