Hepatitis C Management

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Question:

What is the prognosis for a 45-year-old woman with hepatitis C, recently diagnosed gestational diabetes, and stage 1 liver cancer who is 7 months into her second pregnancy?

The answer depends on many factors. Presumably, the patient has fairly well preserved synthetic function since she was able to become pregnant. If this is the case, then the most important factor is the number of lesions, size of the lesions, and evidence of metastatic spread. If there is no metastases or vascular invasion, the prognosis may be excellent. Options for treatment include resection, radiofrequency ablation, chemoembolization, and liver transplantation. The optimal decision depends on the patient’s overall medical condition and the above-mentioned tumor factors. I would recommend close consultation between the hepatology team and the patient’s obstetrician in determining the urgency of treating the cancer weighed against the risks involved with early delivery of the baby. If the cancer is small and isolated, close monitoring until the natural delivery of the baby may be possible.

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