Clinical analysis of pregnancy complicating hepatic carcinoma

2012 
Objective To studies the clinical feature and biomarkers of pregnancy complicating hepatic carcinoma and increase the clinical diagnose rate. Methods Clinical data of 9 pregnant women with liver carcinoma admitted into the obstetrics and gynecology department of the Third Affiliated Hospital of Sun Yat-sen University from July 2008 to June 2012 were retrospectively analyzed.Clinical data included radiology data, serological biomarkers, treatment and follow up observations. Results Among the 9 patients, clinical manifestations were not unique and the liver function did not appear serious injury at the beginning. Two women were diagnosed as liver carcinoma at the second trimester of pregnancy and 7 at late trimester of pregnancy. The treatments included hepatic artery embolization, interventional therapy and liver tumor resection. The outcomes of the pregnant women were not good. Five patients had spontaneous rupture and bleeding of liver carcinoma. During follow up observations, four patients were alive, three patients died and the other two lost. Color doppler ultrasound showed cirrhosis of the liver. Serological biomarkers showed hepatitis B surface antigen (HBsAg) was positive in the nine patients and hepatitis B virus DNA (HBV DNA) replicated in different levels. Alpha fetoprotein(AFP)was significantly associated with liver carcinoma during pregnancy, but it was not the same as alpha-L-fucosidase(AFU). Conclusions It is hard to diagnose liver carcinoma in early trimester of pregnancy and the prognosis is bad.Pregnancy with cirrhosis, as high risk patients, should accept regular examination using ultrasound test in addition to AFP. Key words: Pregnancy, high-risk; Liver neoplasms; Liver cirrhosis
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