Pregnancy-associated liver disease: a curriculum-based review

Kelly, Claire; Pericleous, Marinos

doi:10.1136/flgastro-2017-100924

Cited by 16 publications

(15 citation statements)

References 18 publications

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“…As a result, most authors don't consider it a liver disease per se [12]. Studies have shown that derangement in LFT occurs in half of the patients with HG, and the biochemical abnormalities resolve on cessation of vomiting [17]. The findings of our study are in agreement with the data available.…”

Section: Discussionsupporting

confidence: 88%

Study of Liver Dysfunction in Hyperemesis Gravidarum

Gaba

2020

Cureus

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Introduction Hyperemesis gravidarum (HG) is said to occur when early pregnancy is complicated by excessive vomiting that leads to electrolyte imbalance, ketosis or loss of more than 5% of the bodyweight. It can be accompanied by deranged liver function tests (LFT), and most patients recover uneventfully with no fetal harm. Methods A retrospective study was conducted by evaluating records of 135 patients who were admitted or underwent day care for HG at our center over a period of 30 months. After excluding patients who were not investigated and those with another pre-existing or newly diagnosed liver disease, 63 patients were enrolled in the study. Their LFT were analyzed with the software Graphpad Prism version 8.4 (GraphPad Software, San Diego, California). The values were expressed as mean ± standard deviation and statistical analysis was done using unpaired t test and simple linear regression. Results The mean age of the study population was 26.59 ± 5.15 years and the mean period of gestation was 13.27 ± 2.48 weeks. 60.3% (38/63) of the patients had some form of abnormality on the LFT. The mean total serum bilirubin (TSB) was 1.56 ± 0.84 mg/dL, mean aspartate transaminase (AST) was 46.63 ± 30.89 U/L and mean alanine transaminase (ALT) was 51.35 ± 42.86 U/L. ALT was higher than AST with statistical significance (p<0.0001). There was no statistically significant difference in the LFT of primigravida and multigravida women. The study population included three diabetic and two hypertensive women, and two women had multiple pregnancy. All the patients were treated with anti-emetics. One patient required corticosteroid administration, and none required termination of pregnancy. Conclusion Mild liver dysfunction in HG can occur in over 50% of the patients. When diagnosis is not in doubt, no further intervention is required with regard to the LFT.

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Section: Discussionsupporting

confidence: 88%

Study of Liver Dysfunction in Hyperemesis Gravidarum

Gaba

2020

Cureus

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“…Intrahepatic cholestasis of pregnancy affects 0.1-2% of pregnant women; in 1-4 women, gestation can be complicated by premature birth, fetal asphyxia, meconium staining of amniotic fluid, and stillbirth. The results of a large Swedish cohort study showed that pregnancy, in which the concentration of bile acid in maternal serum is 40 μmol/L or more, can be complicated by spontaneous preterm delivery 23 , the presence of meconium in the amniotic fluid and fetal asphyxia. Another UK cohort study confirms these findings and showed that pregnancy outcomes 22 in women with intrahepatic cholestasis in pregnant women and a serum bile acid concentration of 40 μmol/L or more often lead to fetal death compared to 2205 women with uncomplicated pregnancy 25 .…”

Section: Kremer Et Almentioning

confidence: 99%

Peculiarities of the Pregnancy in Women with Hepatobiliary System Pathology

2020

IJFMT

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During pregnancy, there is a significant restructuring of various organs and systems, including liver functions. Due to the increase in circulating blood volume, most indicators of liver function may differ from their level in non-pregnant women. In the liver of pregnant women, the synthesis of a large class of proteins (excluding immunoglobulins), fibrinogen, prothrombin, blood coagulation factors (V, VII, X, XI, XII, XIII), fibrinolytic factors (antithrombin III, proteins C and S) increases. Hepatic enzymes (serum transaminases, γ-glutamyltranspeptidase), as well as the bilirubin content do not change during the physiological course of pregnancy 1 .

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“…In mild cases of preeclampsia, there is a mild elevation of serum AST/ALT/Alkaline phosphatase. During HELLP syndrome, serum aminotransferases are more than ten times elevated, and unconjugated hyperbilirubinemia may be present due to hemolysis (Kelly, 2018).…”

Section: Biological Evaluation Of the Thyroid The Liver The Kidneysmentioning

confidence: 99%

How can we make pregnancy safe for women with Turner syndrome?

Donadille¹,

Bernard²,

Christin-Maître

2019

American J of Med Genetics Pt C

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Pregnancy is a crucial issue in patients with Turner syndrome (TS). Although natural pregnancies have been reported in 4-7% of TS patients, most women will need assisted reproductive technologies (ART) with oocyte donation. The main issue is the maternal mortality rate that is higher than in the general population. It is related to cardiovascular anomalies and particularly aortic dissection. Turner syndrome, per se, is not a contraindication for pregnancy, but a multidisciplinary screening is mandatory before initiating a pregnancy. It includes repeated aortic diameters evaluation, blood pressure measurement and biological testing evaluating thyroid and liver functions, as well as blood glucose level. In order to make the pregnancy safe, contraindications of pregnancy should be respected and identification of high-risk patients for cardiovascular events should be performed. Hypertension and pre-eclampsia prevention may benefit from beta-blockers and aspirin, respectively. Collaborations between endocrinologists, cardiologists and obstetricians are mandatory during pregnancy and even in the post-partum period. Counseling the patients about the risks of pregnancy, screening them and spreading the international guidelines to physicians taking care of patients with TS are the three pillars of a safe pregnancy.

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Pregnancy-associated liver disease: a curriculum-based review

Cited by 16 publications

References 18 publications

Study of Liver Dysfunction in Hyperemesis Gravidarum

Study of Liver Dysfunction in Hyperemesis Gravidarum

Peculiarities of the Pregnancy in Women with Hepatobiliary System Pathology

How can we make pregnancy safe for women with Turner syndrome?

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