Review article: The management of cirrhosis in women

Alina Allen, J. E. Hay

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Results Pre-menopausal status is protective in viral hepatitis C and non-alcoholic steatohepatitis. However, smoking, especially in combination with alcohol, is a stronger risk factor for cirrhosis and malignancies in women with chronic liver disease compared to men, although they are less likely than men to develop hepatocellular carcinoma. Women with cirrhosis have more osteopenic bone disease than men and require active management. Successful pregnancy is possible in well-compensated cirrhosis or with mild portal hypertension, although the maternal and foetal mortality and morbidity are higher than in the general population. The maternal risk correlates with liver disease severity and derives mostly from variceal bleeding. The choices for contraception in compensated cirrhosis are generally the same as for the general population. Women with cirrhosis are disadvantaged by the current MELD system of organ allocation, at least in part due to body size.

Background There are differences in the predisposition, natural history of liver disease, complications and treatment response between men and women.

Aim To review clinical differences in cirrhosis between men and women and to address unique management issues of fertility, pregnancy and contraception in this patient population.

Methods PubMed and MEDLINE were searched using the terms 'cirrhosis' and 'chronic liver disease', each cross-referenced with specific liver diseases, as well as terms such as 'cancer', 'hepatocellular carcinoma', 'smoking', 'liver transplantation', 'metabolic bone disease', 'fertility',' pregnancy' and 'contraception'.

Conclusion The management of women with chronic liver disease is unique in regards to counselling, screening for complications, fertility and pregnancy.

Original languageEnglish (US)
Pages (from-to)1146-1154
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume40
Issue number10
DOIs
StatePublished - Jan 1 2014

Fingerprint

Fibrosis
Liver Diseases
Contraception
Fertility
Chronic Disease
Pregnancy
Hepatocellular Carcinoma
Smoking
Population
Fetal Mortality
Pregnancy Complications
Maternal Mortality
Metabolic Bone Diseases
Bone Diseases
Body Size
Portal Hypertension
Vulnerable Populations
Fatty Liver
Hepatitis C
PubMed

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Review article : The management of cirrhosis in women. / Allen, Alina; Hay, J. E.

In: Alimentary Pharmacology and Therapeutics, Vol. 40, No. 10, 01.01.2014, p. 1146-1154.

Research output: Contribution to journalReview article

@article{16fbd6ee70854058887e80c593ee3825,
title = "Review article: The management of cirrhosis in women",
abstract = "Results Pre-menopausal status is protective in viral hepatitis C and non-alcoholic steatohepatitis. However, smoking, especially in combination with alcohol, is a stronger risk factor for cirrhosis and malignancies in women with chronic liver disease compared to men, although they are less likely than men to develop hepatocellular carcinoma. Women with cirrhosis have more osteopenic bone disease than men and require active management. Successful pregnancy is possible in well-compensated cirrhosis or with mild portal hypertension, although the maternal and foetal mortality and morbidity are higher than in the general population. The maternal risk correlates with liver disease severity and derives mostly from variceal bleeding. The choices for contraception in compensated cirrhosis are generally the same as for the general population. Women with cirrhosis are disadvantaged by the current MELD system of organ allocation, at least in part due to body size.Background There are differences in the predisposition, natural history of liver disease, complications and treatment response between men and women.Aim To review clinical differences in cirrhosis between men and women and to address unique management issues of fertility, pregnancy and contraception in this patient population.Methods PubMed and MEDLINE were searched using the terms 'cirrhosis' and 'chronic liver disease', each cross-referenced with specific liver diseases, as well as terms such as 'cancer', 'hepatocellular carcinoma', 'smoking', 'liver transplantation', 'metabolic bone disease', 'fertility',' pregnancy' and 'contraception'.Conclusion The management of women with chronic liver disease is unique in regards to counselling, screening for complications, fertility and pregnancy.",
author = "Alina Allen and Hay, {J. E.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1111/apt.12974",
language = "English (US)",
volume = "40",
pages = "1146--1154",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Review article

T2 - The management of cirrhosis in women

AU - Allen, Alina

AU - Hay, J. E.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Results Pre-menopausal status is protective in viral hepatitis C and non-alcoholic steatohepatitis. However, smoking, especially in combination with alcohol, is a stronger risk factor for cirrhosis and malignancies in women with chronic liver disease compared to men, although they are less likely than men to develop hepatocellular carcinoma. Women with cirrhosis have more osteopenic bone disease than men and require active management. Successful pregnancy is possible in well-compensated cirrhosis or with mild portal hypertension, although the maternal and foetal mortality and morbidity are higher than in the general population. The maternal risk correlates with liver disease severity and derives mostly from variceal bleeding. The choices for contraception in compensated cirrhosis are generally the same as for the general population. Women with cirrhosis are disadvantaged by the current MELD system of organ allocation, at least in part due to body size.Background There are differences in the predisposition, natural history of liver disease, complications and treatment response between men and women.Aim To review clinical differences in cirrhosis between men and women and to address unique management issues of fertility, pregnancy and contraception in this patient population.Methods PubMed and MEDLINE were searched using the terms 'cirrhosis' and 'chronic liver disease', each cross-referenced with specific liver diseases, as well as terms such as 'cancer', 'hepatocellular carcinoma', 'smoking', 'liver transplantation', 'metabolic bone disease', 'fertility',' pregnancy' and 'contraception'.Conclusion The management of women with chronic liver disease is unique in regards to counselling, screening for complications, fertility and pregnancy.

AB - Results Pre-menopausal status is protective in viral hepatitis C and non-alcoholic steatohepatitis. However, smoking, especially in combination with alcohol, is a stronger risk factor for cirrhosis and malignancies in women with chronic liver disease compared to men, although they are less likely than men to develop hepatocellular carcinoma. Women with cirrhosis have more osteopenic bone disease than men and require active management. Successful pregnancy is possible in well-compensated cirrhosis or with mild portal hypertension, although the maternal and foetal mortality and morbidity are higher than in the general population. The maternal risk correlates with liver disease severity and derives mostly from variceal bleeding. The choices for contraception in compensated cirrhosis are generally the same as for the general population. Women with cirrhosis are disadvantaged by the current MELD system of organ allocation, at least in part due to body size.Background There are differences in the predisposition, natural history of liver disease, complications and treatment response between men and women.Aim To review clinical differences in cirrhosis between men and women and to address unique management issues of fertility, pregnancy and contraception in this patient population.Methods PubMed and MEDLINE were searched using the terms 'cirrhosis' and 'chronic liver disease', each cross-referenced with specific liver diseases, as well as terms such as 'cancer', 'hepatocellular carcinoma', 'smoking', 'liver transplantation', 'metabolic bone disease', 'fertility',' pregnancy' and 'contraception'.Conclusion The management of women with chronic liver disease is unique in regards to counselling, screening for complications, fertility and pregnancy.

UR - http://www.scopus.com/inward/record.url?scp=84908371377&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908371377&partnerID=8YFLogxK

U2 - 10.1111/apt.12974

DO - 10.1111/apt.12974

M3 - Review article

C2 - 25263269

AN - SCOPUS:84908371377

VL - 40

SP - 1146

EP - 1154

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 10

ER -