# Preexisting Liver Disease and Pregnancy: Optimizing Care to Optimize Outcomes

## TL;DR

This review discusses managing pregnancies in women with preexisting liver disease to improve maternal and fetal outcomes through multidisciplinary care.

## Contribution

The paper provides a comprehensive review of current evidence and management strategies for pregnancy in women with various types of preexisting liver disease.

## Key findings

- Pregnancy in women with liver disease requires multidisciplinary care to manage risks.
- Adverse maternal and fetal outcomes are more common in women with preexisting liver conditions.
- Proactive management from preconception through postpartum improves safety and outcomes.

## Abstract

Preexisting liver disease, particularly the presence of cirrhosis and portal hypertension (PHT), presents a significant challenge during gestation, necessitating close collaboration between obstetric and hepatology/gastroenterology teams. Women with underlying liver conditions face an increased likelihood of adverse maternal and fetal outcomes. Proactive identification and management of the potential risks associated with pregnancy in this patient group is therefore crucial. While the desire to start a family is deeply personal, each pregnancy carries unique risks requiring careful consideration. Although no single recommendation can comprehensively address all forms of liver disease, pregnancy in women with underlying hepatic conditions can be both safe and achievable when managed through a multidisciplinary team approach, involving the mother and her partner from the preconception stage through to the postpartum period. This review summarizes the current evidence regarding the risks and management strategies for pregnancy complicated by preexisting liver disease, including cirrhosis and PHT, steatotic liver disease, viral hepatitis, autoimmune liver disease, and liver transplant recipients.