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Fertility becomes nearly normal when cirrhosis is well compensated or the active liver disease improves with appropriate therapy (e.g., autoimmune wilson disease hepatitis on steroids). The degree of hepatic impairment determines the risk for the mother during the pregnancy. Hemorrhage from esophageal varices is the most significant complication of cirrhosis in pregnancy. The increased blood volume wilson disease and flow through the azygous system that are a part of any normal pregnancy raise the pressure wilson disease in the esophageal veins; in established cirrhosis this increases variceal size and the likelihood of bleeding. 17.4 Liver Diseases Unique to Pregnancy page 553 17.4.1 ACUTE FATTY LIVER OF PREGNANCY Acute fatty liver of pregnancy is characterized by fatty infiltration of the liver. It may rapidly progress to hepatic failure and death.
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