Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review.
HPB (Oxford)
; 23(8): 1152-1163, 2021 08.
Article
em En
| MEDLINE
| ID: mdl-33985906
ABSTRACT
BACKGROUND:
Hepatocellular adenomas (HCA) are benign liver tumors at risk of hemorrhage. The influence of pregnancy on HCA growth and potential bleeding remains unclear. This study investigates HCA-associated behavior and bleeding complications during or shortly after pregnancy.METHODS:
(I) Single center retrospective cohort study of HCA during and after pregnancy (II) Systematic literature review.RESULTS:
The retrospective study included 11 patients, of which 4 with HCA ≥5 cm. In only two patients HCA showed growth during pregnancy. In this local cohort, no HCA-related hemorrhages occurred during median follow-up of 34 months (interquartile range 19-58 months). The systematic review yielded 33 studies, totaling 90 patients with 99 pregnancies. Of 73 pregnancies without prior HCA-related intervention, 39 HCA remained stable (53.4%), 11 regressed (15.1%), and 23 (31.5%) progressed. Fifteen HCA-related hemorrhages occurred in HCA measuring 6.5-17.0 cm. Eight patients experienced bleeding during pregnancy, two during labor and five postpartum.CONCLUSION:
Although hemorrhage of HCA during or shortly after pregnancy is rare and only reported in HCA ≥6.5 cm, it can be fatal. Pregnancy in women with HCA, regardless of size, warrant a close surveillance strategy. Observational studies on behavior and management of HCA ≥5 cm during and immediately after pregnancy are needed.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Adenoma de Células Hepáticas
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Carcinoma Hepatocelular
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Neoplasias Hepáticas
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article