Alterations in liver function during normal pregnancy

McNair, Ruth D.; Jaynes, R. V.

doi:10.1016/s0002-9378(16)36504-8

Cited by 35 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although standard texts still suggest that pregnancy does not alter hepatic function in humans, elevation of serum levels of alkaline phosphatase is common during the last trimester (37)(38)(39)(40) (6). The results of the present study are consistent with this view and indicate that estrogens in particular may account wholly, or in part, for the maternal hepatic functional alterations described.…”

Section: Discussionsupporting

confidence: 84%

Estrogen Pharmacology. I. The Influence of Estradiol and Estriol on Hepatic Disposal of Sulfobromophthalein (BSP) in Man*

Mueller¹,

Kappas²

1964

J. Clin. Invest.

137

View full text Add to dashboard Cite

This report 1 describes the influence of natural estrogens on liver function, with special reference to sulfobromophthalein (BSP) excretion, in man. Pharmacological amounts of the hormone estradiol consistently induced alterations in BSP disposal that were shown, through the techniques of Wheeler and associates (2, 3), to result from profound depression of the hepatic secretory transport maximum (Tm) for the dye. Chromatographic analysis of plasma BSP components revealed increased amounts of BSP conjugates during estrogen as compared with control periods, implying a hormonal effect on cellular processes concerned with transport of dye from hepatocytes into biliary canaliculi. Estriol, an in vivo transformation product of estradiol, also impaired hepatic disposal of BSP in man. According to unpublished data of Hertz (4) 2 estrone, ethinyl estradiol, and equine estrogens act similarly, and it is likely that other C-18 steroids of both physiologic and synthetic origin have this property as well. These observations define a new * Submitted for publication April 13, 1964; accepted June 16, 1964. biological action of natural estrogens in man, further substantiate the role of the liver as a site of action of these hormones (5), and probably account, in part, for the impairment of BSP disposal that characterizes pregnancy (6) and the neonatal period (7-10). MethodsSteroid solutions were prepared by dissolving crystalline estradiol and estriol in a solvent vehicle containing 10% N,NDMA (N,N-dimethylacetamide) 3 in propylene glycol. Estradiol was soluble in a concentration of 100 mg per ml; estriol, in a concentration of 20 mg per ml. These, together with appropriate control solutions, were sterilized by filtration at room temperature and administered to patients by intramuscular injection. All subjects were housed on a metabolic ward during the study, and a number were maintained on fixed diets as required by concurrent investigations. The principal clinical diagnoses were rheumatoid arthritis and related connective tissue disorders. The observations reported here were made during a series of studies designed initially to examine the potential use of pharmacological amounts of natural estrogens as therapeutic or immunosuppressive (11)(12)(13) agents in man; the periods of estrogen administration therefore varied considerably from subj ect to subject. Liver function was examined in these patients by the following tests: per cent esterification of cholesterol, direct and indirect bilirubin, cephalin and thymol flocculations, thymol turbidity, prothrombin time, serum albumin and globulin, retention of BSP in plasma 45 minutes after intravenous administration of 5 mg per kg body weight, and the following serum enzymes: alkaline phosphatase, lactic dehydrogenase (LDH), glutamic pyruvic transaminase (SGPT), and glutamic oxaloacetic transaminase (SGOT). BSP infusion studies, chromatography of plasma BSP components, and liver biopsies were performed in several subjects as described below.Thirty-one patients were treated wit...

show abstract

Section: Discussionsupporting

confidence: 84%

Estrogen Pharmacology. I. The Influence of Estradiol and Estriol on Hepatic Disposal of Sulfobromophthalein (BSP) in Man*

Mueller¹,

Kappas²

1964

J. Clin. Invest.

137

View full text Add to dashboard Cite

show abstract

“…We conclude that in terms of better Apgar and NAC scores, acid-base status and earlier initiation of breast-feeding, the epidural anesthesia may be preferred to general anesthesia in cesarean section. Copyright © 2003 S. Karger AG, Basel Although the anesthetic technique that should be performed in cesarean section was determined by the factors as the urgency of the section, presence of patient's additional health problems, patient's and surgeon's choice and the experience of the anesthesiologist, general anesthesia is favoured because of rapid induction in many institutes.General anesthesia in cesarean section may cause problems such as maternal aspiration of the gastric content, difficulty in intubation, fetal distress caused by administration of anesthetic agents, low Apgar and Neurologic and Adaptive Capacity scores (NACS) in neonates, postpartum hemorrhage, postoperative pain, delayed mobilization, increased thromboembolism risk and prolonged breast-feeding interval [1][2][3]. However, these risk factors seem to disappear when regional anesthesia methods were performed.…”

mentioning

confidence: 99%

Comparison of Neonatal Effects of Epidural and General Anesthesia for Cesarean Section

Şener¹,

Güldoğuş²,

Karakaya³

et al. 2003

Gynecol Obstet Invest

View full text Add to dashboard Cite

We assessed the influence of anesthetic technique for cesarean section on neonatal outcome. Thirty parturient women (ASA I/II) were randomly allocated into two groups. In Group GA general anesthesia was induced with 4 mg·kg^–1 thiopental and 1.5 mg·kg^–1 succinylcholine. In group EA epidural anesthesia was performed with 20 ml 0.375% bupivacaine through L_3–4 inter-space. 1-min Apgar scores were significantly higher in group EA (p < 0.001). Neurologic and Adaptive Capacity scores at 2 and 24 h were higher in group EA (p < 0.001). In terms of blood gas values, umbilical arterial pH and pO₂ values were higher in group EA (p < 0.05 and p < 0.001, respectively). The first breast-feeding intervals were found to be shorter in group EA (p < 0.001). We conclude that in terms of better Apgar and NAC scores, acid-base status and earlier initiation of breast-feeding, the epidural anesthesia may be preferred to general anesthesia in cesarean section.

show abstract

“…A considerable number of these results show raised alkaline phosphatase (Wetstone et al, 1958;McNair and Jaynes, 1960;Kubli, 1961;Dass and Bhagwanani, 1964). Pathological values in thymol turbidity test were noted in 0-15 per cent of the cases examined (Christhilf and Bonsnes, 1950; Wetstone et al, 1958;McNair and Jaynes, 1960; Friedberg, 1962). The bromsulphthalein test was found to be normal (Christhilf and Bonsnes, 1950;Brewer and Hjelte, 1965), and pathological in only a small number of cases (Friedberg, 1962).…”

mentioning

confidence: 98%

“…Cavnlli (1 964) reported that bromsulphthalein clearance was reduced during pregnancy. Total cholesterol increases, in most patients, towards the end of pregnancy (Wetstone et al, 1958;McNair and Jaynes, 1960), while serum transaminases usually remain normal. Total serum bilirubin in the large series of 564 pregnant women reported by McNair and Jaynes (1960) exceeded 1 mg O!o in only 4 per cent of the patients, while none were over 2 mg Yo.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Hepatobiliary Function In Puerperium After Normal Pregnancy And Toxaemia Of Late Pregnancy, With Special Reference To The Radioactive Rose Bengal Test

Ylöstalo¹,

Jussila²,

Rekonen³

1967

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

Liver function tests during normal pregnancy often show abnormal values; a comprehensive report on these tests has recently been published by Haemmerli (1966). A considerable number of these results show raised alkaline phosphatase (Wetstone et al., 1958;McNair and Jaynes, 1960;Kubli, 1961;Dass and Bhagwanani, 1964). Pathological values in thymol turbidity test were noted in 0-15 per cent of the cases examined (Christhilf and Bonsnes, 1950; Wetstone et al., 1958;McNair and Jaynes, 1960; Friedberg, 1962). The bromsulphthalein test was found to be normal (Christhilf and Bonsnes, 1950;Brewer and Hjelte, 1965), and pathological in only a small number of cases (Friedberg, 1962). Cavnlli (1 964) reported that bromsulphthalein clearance was reduced during pregnancy. Total cholesterol increases, in most patients, towards the end of pregnancy (Wetstone et al., 1958;McNair and Jaynes, 1960), while serum transaminases usually remain normal. Total serum bilirubin in the large series of 564 pregnant women reported by McNair and Jaynes (1960) exceeded 1 mg O!o in only 4 per cent of the patients, while none were over 2 mg Yo. The histological picture of the liver is normal during a normal pregnancy (Ingerslev and Teilum, 1945 (I); Antia et al., 1958). The relative blood flow of the liver is reduced during pregnancy, while the absolute

show abstract

Alterations in liver function during normal pregnancy

Cited by 35 publications

References 12 publications

Estrogen Pharmacology. I. The Influence of Estradiol and Estriol on Hepatic Disposal of Sulfobromophthalein (BSP) in Man*

Estrogen Pharmacology. I. The Influence of Estradiol and Estriol on Hepatic Disposal of Sulfobromophthalein (BSP) in Man*

Comparison of Neonatal Effects of Epidural and General Anesthesia for Cesarean Section

Hepatobiliary Function In Puerperium After Normal Pregnancy And Toxaemia Of Late Pregnancy, With Special Reference To The Radioactive Rose Bengal Test

Contact Info

Product

Resources

About