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Behavior and complications of hepatocellular adenoma during pregnancy and puerperium: a retrospective study and systematic review
- Source :
- HPB : the official journal of the International Hepato Pancreato Biliary Association. 23(8)
- Publication Year :
- 2021
-
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.
- Subjects :
- medicine.medical_specialty
Carcinoma, Hepatocellular
Single Center
Adenoma, Liver Cell
03 medical and health sciences
0302 clinical medicine
Interquartile range
Pregnancy
Medicine
Humans
Retrospective Studies
Hepatology
business.industry
Obstetrics
Liver Neoplasms
Postpartum Period
Gastroenterology
Retrospective cohort study
Hepatocellular adenoma
medicine.disease
Systematic review
030220 oncology & carcinogenesis
Cohort
030211 gastroenterology & hepatology
Observational study
Female
business
Subjects
Details
- ISSN :
- 14772574
- Volume :
- 23
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Accession number :
- edsair.doi.dedup.....201a2d0ed9cc4bc81c8776c499a7ac8c