Pregnancy associated with primary hepatocellular carcinoma.

Abstract

Hepatocellular carcinoma is a rare complication of pregnancy. Three cases of pregnancy complicated by primary hepatocellular carcinoma were seen at our hospital in 3 years. Two were diagnosed antepartum and one postpartum. In one instance, the diagnosis came from finding elevated maternal serum alpha-fetoprotein (MSAFP) with normal amniotic fluid (AF) AFP. Positive hepatitis B surface antigen and liver cirrhosis were found in all three cases, but liver enzymes were only slightly elevated. All three women died, as did one of the fetuses. Careful MSAFP screening and interpretation, followed by AFAFP and abdominal sonography, seem to be the best tools for early diagnosis of primary hepatocellular carcinoma in pregnant women.