1. Pregnancy in Primary Sclerosing Cholangitis

2. 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)

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

4. 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)

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

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

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

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