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Thématique :
- Foie
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2018/08  
 
  2018 Aug;68(2):625-633.  
  doi: 10.1002/hep.29345  
 
  Pregnancy outcome in women undergoing liver biopsy during pregnancy: A nationwide population-based cohort study.  
 
  Ludvigsson JF, Marschall HU, Hagström H, Höijer J, Stephansson O  
  https://www.ncbi.nlm.nih.gov/pubmed/28653764  
 
 

Abstract
 

Liver biopsy is an important procedure in the investigation of liver disease. We examined pregnancy outcomes in women who underwent liver biopsy during pregnancy. In a nationwide population-based cohort study we linked data from the Swedish Medical Birth Registry (for births between 1992 and 2011) with those from the Swedish Patient Registry. We identified 23 pregnancies exposed to liver biopsy. We calculated relative risks (RRs) for adverse pregnancy outcomes according to liver biopsy status using 1,953,887 unexposed pregnancies with and without a record of liver disease as reference. Our main outcome measures were stillbirth and preterm birth. There were no stillbirths in pregnancies exposed to liver biopsies compared with 0.3% stillbirths in unexposed pregnancies, and 3/23 (13%) exposed pregnancies were preterm (RR, 2.6; 95% confidence interval, 0.9-7.5). Compared to women with a record of liver disease, preterm birth was not increased in those exposed to liver biopsy (RR, 0.9; 95% confidence interval, 0.1-6.0). Except for an increased risk of small for gestational age birth in pregnancies exposed to liver biopsy (RR, 5.2; 95% confidence interval, 1.8-14.8), other adverse pregnancy outcomes were independent of liver biopsy status when the analysis was restricted to women with a diagnosis of liver disease. Compared with unexposed sibling pregnancies, pregnancies with a liver biopsy were 7 days shorter, but birth weights did not differ between the siblings (-67 g; P > 0.05).

CONCLUSION:

Apart from a moderately increased risk of preterm birth and small for gestational age, there was no association between liver biopsy during pregnancy and adverse pregnancy outcome; potential excess risks should be weighed against the advantages of having a liver biopsy that may influence clinical management of the patient and indirectly fetal health. (Hepatology 2017).

 
Question posée
 
Devenir de la grossesse chez les femmes ayant eu une biopsie hépatique (PBH) durant leur grossesse.
 
Question posée
 
Sur les 1,9 millions de naissances étudiés dans le registre suédois des naissances, en 20 ans, 23 femmes ont eu une PBH (surtout lors du 1er trimestre) ayant donné lieu à 17 diagnostics « codables » de maladie hépatique. Il n’a pas été noté d’incidence de la PBH sur la grossesse.
 
Commentaires

Même si la PBH apparait sûre au cours de la grossesse (1er trimestre), le bon sens clinique et le bon sens tout court doivent limiter ce geste !

 
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