Liver problems in pregnancy: part 2--managing pre-existing and pregnancy-induced liver disease.

[benign recurrent intrahepatic cholestasis]

In distinguishing normal from abnormal hepatic changes , the author described the expected changes in liver tests that occur during complicated pregnancy . This article reviews the forms of pre-existing liver disease that may affect or be affected by pregnancy , as well as liver diseases that tend to arise during pregnancy . Among the pre-existing liver diseases are autoimmune chronic active hepatitis , which may be activated by pregnancy and tends to be associated with an increased risk of still and premature births . Worsening of chronic hepatitis B and C has occasionally been observed . While some women with cirrhosis can sustain a normal pregnancy without any worsening of hepatic function , others develop liver failure ; plus , women with cirrhosis are less fertile and have higher rates of both stillbirths and premature infants . Other liver disorders that may or may not be affected by pregnancy include Dubin-Johnson syndrome , Gilbert syndrome , benign recurrent intrahepatic cholestasis , Wilson 's disease , hepatic adenomas , and focal nodular hyperplasia . Among the hepatic disorders that occur during pregnancy in normally healthy women and then resolve after delivery is intrahepatic cholestasis of pregnancy (also known as pruritus gravidarum , recurrent intrahepatic cholestasis of pregnancy , and obstetric hepatosis ). Others include acute fatty liver of pregnancy and HELLP syndrome (hemolysis , elevated liver enzymes , and low platelet count ), which may be part of the spectrum of disorders associated with pre-eclampsia /eclampsia . Pregnancy may also trigger the dissemination of herpes infection to the liver .

Diseases
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Diseases presenting "hepatic function" symptom

benign recurrent intrahepatic cholestasis

heparin-induced thrombocytopenia

primary hyperoxaluria type 1

scrub typhus

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