Portal de Periódicos da CAPES

Deficiencies in reproductive health counseling in liver transplant recipients

2019; Wiley; Volume: 33; Issue: 8 Linguagem: Inglês

10.1111/ctr.13631

1399-0012

Paulina K. Phillips, Sumona Saha, David P. Foley, Jesus Igor Iruretagoyena, Adnan Said,

Pregnancy and preeclampsia studies

Abstract Background In liver transplant (LT) recipients of childbearing age, there is often rapid return of fertility post‐transplant. Our aim was to determine whether healthcare providers are documenting reproductive health counseling in LT recipients. Methods We performed a review of 365 LT recipients (164 female, 201 male) of childbearing age transplanted between 1994 and 2015 at a single center. We evaluated documentation of reproductive health counseling, content of the counseling and its provider. Results Reproductive health counseling was documented in 7% of LT recipients (14% of females, 0.5% of males). The transplant team provided the counseling in 56%, obstetrics/gynecology in 35%, and primary care in 9%. Twenty‐four post‐LT pregnancies occurred; these were unplanned in 13%. Miscarriage/stillbirth occurred in 7/24 pregnancies (29%). Mycophenolic acid was used by 20% of female recipients at conception. Only age at transplant ( P = 0.001) and post‐LT pregnancy was associated with documentation of reproductive health counseling in female recipients ( P = 0.0001). Conclusion Despite rapid return of fertility in reproductive‐aged LT recipients, documentation of reproductive health counseling in this population is rare in men and women. This increases the potential for adverse maternal and fetal outcomes in this high‐risk population.