Implications for research
While our systematic review was able to quantify the increased risks of
liver cirrhosis in pregnancy, we were insufficiently powered to
demonstrate whether emerging management options have lowered some, or
all of these risks. Our study was not able to provide evidence on the
patient selection most likely to benefit from such management options.
In particular more data regarding course and treatment of liver
cirrhosis during pregnancy and treatment of specific complications (e.g.
variceal hemorrhage, ascites, jaundice, hepatic encephalopathy) are
needed to improve the knowledge and management of women with these
health issues and identify the women more at risk than others. We
suggest large prospective international studies could provide evidence
for many of these knowledge gaps, and could investigate which diagnostic
and treatment entities contribute to improved perinatal outcomes over
time.