Liver and gastrointestinal function in pregnancy

Abstract

Summary Difficulties arise in the interpretation of liver tests in the pregnant subject, since some values increase (alkaline phosphatase) whilst others remain unchanged (transaminases) or fall during pregnancy. The diagnosis and management of some causes of jaundice in pregnancy, such as viral hepatitis, gall stones, benign intrahepatic cholestasis and acute fatty liver of pregnancy are discussed. Little is known about the commonest symptoms of pregnancy (nausea, vomiting and constipation) other than that they might be due to hormonally induced alteration of sphincter tone. However, pre-existing bowel disease has a greater effect on pregnancy. Fertility is reduced in poor nutritional states (e.g. coeliac and Crohn's diseases) and an increased occurrence of spontaneous abortion has been noted. For inflammatory bowel diseases, the time of onset is important in determining the outcome of pregnancy. Relapse in the disease is commonest in the first trimester and in the puerperium. Treatment of these conditions is essentially as in the non-pregnant subject. The controversial subject of sulphasalazine and steroid usage in pregnancy is discussed.

Study of Platelet Count and Liver Function Test in Pregnency Induced Hypertension Women

“…(2) including 85 patients with PIH, AST, ALT were elevated in 54% of patients with pre-eclampsia, whereas in cases of gestational hypertension they were raised only in 14% of cases.…”

Perinatal Outcome in Severe Preeclampsia Patients in Relation to Altered LFT

“…Abnormal liver function tests occur in 20% to 30% of pregnancies complicated by pre-eclampsia and are associated with poor maternal and fetal outcomes. 11,12,14 Various authors have reported alterations in liver enzymes in preeclampsia patients. [15][16][17] Age and parity (Graph 1 and 2): Spectrum of pre-eclampsia is more common in extremes, of reproductive age groups.…”