Anaesthetic Considerations in Post Liver Transplant Pregnant Woman

Abstract

The pathophysiology of gender differences in the incidence, natural history, and outcomes of common liver diseases is incompletely understood. Various potential mechanisms include the effect of sex hormones on oxidative and metabolic pathways, differential gene transcription in response to injury in women compared with men, and sex differences in immune regulation. In addition, differences in access to care and treatment, as well as diagnostic considerations, may affect gender differences in liver disease. Physiologically, the marked hypothalamic–pituitary– gonadal abnormalities of end-stage liver disease are reversed post-transplantation, although it has been suggested that some transplant recipients may have persisting abnormalities. Functionally, the vast majority of women of child-bearing age will recover regular menstrual bleeding within one year post-transplant and a significant proportion will experience menses within the first month. Sexual health, which encompasses sexual function and satisfaction, however, is influenced by more than just hormonal and endocrinologic physiology. Concomitant health issues, medications, aging, as well as psychological and social issues may also affect post-transplant sexual health.