Liver function tests in normal pregnancy: A prospective study of 103 pregnant women and 103 matched controls

Abstract

Except for increased serum alkaline phosphatase (AP) effects on metabolic, synthetic, and excretory hepatic levels, the changes in liver function test (LFT) values functions. 2 The biliary excretion of bromosulfophthaduring normal pregnancy have not been clearly estab-lein decreases during pregnancy. 3,4 Some authors have lished, mainly because most studies do not include stated that there is a subclinical physiological cholestamatched controls. We therefore measured the serum val-sis during pregnancy. 5 The increase in plasma volume ues of routine liver tests including 5 -nucleotidase and that occurs during pregnancy leads to hemodilution 6,7 total bile acids in 103 healthy pregnant women (first tri-and decreases the serum protein concentrations. Semester, n Å 34; second trimester, n Å 36; third trimester, rum alkaline phosphatase levels increase in late pregn Å 33) and in 103 age-matched controls not receiving nancy because of both a production of the placental oral contraception. Fasting blood samples were taken.isoenzyme and an increase in the bone isoenzyme. [8][9][10] Because of hemodilution, serum albumin levels were significantly lower during all trimesters. As expected, AP It is therefore not surprising that changes in liver funcactivity was significantly higher in the third trimester. tion tests (LFTs) occur during pregnancy. NevertheSerum aspartate transaminase (AST) activity and total less, except for increased alkaline phosphatase levels, bile acid (TBA) concentrations did not differ between which have been clearly demonstrated, the changes in pregnant and nonpregnant women. Serum alanine the other LFT values have not been clearly established, transaminase (ALT) activity was slightly higher in the and a recent review in this field has shown that there second-trimester pregnant women than in controls (6.8 are some discordances in the literature. 11 The identifi-{ 4.5 vs. 8.2 { 5.8, P Å .04), although all values remained cation of these physiological changes is important for within normal limits. In pregnant women, total and free the diagnosis of liver diseases during pregnancy.bilirubin concentrations were significantly lower durThus, the aim of this study was to evaluate the ing all three trimesters, as was conjugated bilirubin during the second and third trimesters. Serum g-glutamyl changes in serum levels of routine LFTs, i.e., alkaline transpeptidase (GGT) activity was significantly lower in phosphatase (AP), alanine transaminase (ALT), asparthe second and third trimesters. Serum 5 -nucleotidase tate transaminase (AST), g-glutamyltranspeptidase activity was slightly but significantly higher in the sec-(GGT), total and conjugated bilirubin, 5 -nucleotidase, ond and third trimesters. The knowledge of these results and total bile acids (TBA) during normal pregnancy is useful for the interpretation of LFT values and the compared with a control group of nonpregnant women. hemodilution. The pregnant woman experiences physiological PATIENTS AND METHODSchanges to support fetal growth and development. Dur...

Chronic hepatitis B virus (HBV) infection in pregnancy

“…We are also aware that we did not include non-HBV infected pregnant females as separate controls. This was because previous study [20] has already shown that s. ALT in pregnancy, albeit higher in the second trimester of pregnancy in normal female subjects when compared with non-pregnant controls, remained well within the normal limits. Thus pregnancy per se could not have accounted for the elevated s. ALT in our pregnant, HBVinfected patients.…”

Pregnancy-Associated Liver Disorders

“…This is accompanied by a lesser increase of red blood cells (RBC) mass (20%), and therefore some degree of dilutional anemia is expected. The serum concentration of albumin decreases significantly as well [9]. In normal pregnancy most liver enzyme tests are unchanged.…”

Trauma in pregnant patients

“…[35][36][37] There is also a decrease in the level of plasma albumin to an average of 3.0 g/dL, but this is probably dilutional and not due to compromised synthetic activity. 38 Renal system…”