Volume 30, Issue 170, April 2026

A rough way to maternity. A case report of successful delivery among a 28-year-old woman with liver cirrhosis due to autoimmune hepatitis and a history of recurrent pregnancy losses

Agata Knap^1♦, Weronika Knap-Wielgus², Bronisława Pietrzak², Maria Gołębiowska³, Dorota Bomba-Opoń², Mirosław Wielgoś²

¹Maternal-Fetal Medicine Student Scientific Association, Medical University of Warsaw, Warsaw, Poland
²Department of Obstetrics and Perinatology, National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland
³Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland

^♦Corresponding author
Agata Knap, Maternal-Fetal Medicine Student Scientific Association, Medical University of Warsaw, Warsaw, Poland

ABSTRACT

Pregnancy in cirrhotic patients, especially when cirrhosis is due to autoimmune hepatitis, has been associated with increased perinatal and maternal mortality. A woman with cirrhosis due to autoimmune hepatitis had a history of recurrent miscarriages and placental abruption. She underwent a preventive procedure of endoscopic variceal ligation before her sixth pregnancy. During this pregnancy, we treated her with progesterone and low-dose ASA to prevent preeclampsia. The woman had recurrent ascites, grade I fetal growth restriction (FGR), intrahepatic cholestasis of pregnancy, and vasa previa. At 30 weeks and 6 days of gestation, the woman underwent an elective cesarean delivery of a healthy premature baby. The patient had a severe postpartum hemorrhage. Hemostatic techniques controlled the bleeding. Delayed wound healing, flare of autoimmune hepatitis with complications, occurred during the postpartum period, which was successfully managed, with the complications resolving. Advanced liver cirrhosis and portal hypertension required intensive medical care. Proactive management steps ensured a successful patient outcome. The case shows how a multifaceted approach can lead to a successful outcome in a complex pregnancy.

Keywords: Liver cirrhosis, Autoimmune hepatitis, High-risk pregnancy, Postpartum hemorrhage, Fetal growth restriction

Medical Science, 2026, 30, e69ms3851

PDF

Published: 12 April 2026