PREGNANCY ASSOCIATED WITH PRIMARY HEPATOCELLULAR-CARCINOMA

Background: Hepatocellular carcinoma is a rare complication of pregnancy. Cases: 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. Conclusion: 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.