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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
Validation
Diseases presenting
"intrahepatic cholestasis"
symptom
benign recurrent intrahepatic cholestasis
zellweger syndrome
This symptom has already been validated