SERPINA1 and Cirrhosis: In fact, of the more than 400 cases reported in the international literature of ruptured SAAs, 30% occurred during pregnancy, and 6% in the postpartum phase.2,3 Multiparity is a strong risk factor with a mean of 3.5 pregnancies.2,4 The risk factors for rupture include aneurysm size greater than two centimeters (cm), female of childbearing age, pregnancy, cirrhosis, liver transplant, and alpha-1 antitrypsin deficiency.5,7