Objectives: To evaluate the maternal, fetal, and neonatal outcomes, and address the factors which influence the maternal outcome in pregnant patients with liver cirrhosis.

Methods: A prospective cohort study which included 129 pregnant patients with liver cirrhosis (study group). A total of two control groups were enrolled; the 1st (pregnant non-cirrhotic; n = 647); the 2nd (non-pregnant cirrhotic; n = 853). The Odds ratios were used to compare the maternal, fetal, neonatal and hepatic complications in the 3 groups.

Results: The maternal, fetal, and neonatal complications were significantly higher in the study than 1st control group. The rate of hepatic decompensation (HD) was higher in the study than 2nd control group (63.6% vs 13.6%). The maternal mortality was higher in the study (7.8%) than 1st (0.2%) and 2nd control group (2.5%). Variceal bleeding during vaginal delivery was the most common cause of maternal mortality. Vaginal delivery and increasing gestational age were the most important variables affected the rate of HD. 

Conclusions: Liver cirrhosis was associated with high maternal and neonatal morbidities and mortalities. Esophageal bleeding during vaginal delivery was the commonest cause of maternal mortality. Increasing gestational age and vaginal delivery were the most important risk factors for HD.