Obstetrical and gynecologic challenges in the liver transplant patient

Table 2 Potential adverse maternal and fetal outcomes of immunosuppressive medication in pregnant liver transplant recipients

Immunosuppressive medication	Adverse outcome	FDA pregnancy category
Calcineurin inhibitors, e.g. cyclosporine, tacrolimus	Maternal diabetes; Hypertension; Pre-eclampsia; Renal dysfunction; Fetal perinatal hyperkalemia	C
Azathioprine	Fetal anemia, thrombocytopenia, leukopenia; Decreased fetal immunoglobulin levels; Neonatal infection and sepsis; Pre-term delivery; Low birth weight	D
Corticosteroids	Gestational hypertension; Gestational diabetes; Fetal adrenal insufficiency; Fetal cleft lip and palate	B
Mycophenolate mofetil	Increased first trimester pregnancy loss; Fetal cleft lip and palate; Microtia; Absence of auditory canals	D

FDA: Food and Drug Administration.