Liver diseases in pregnancy

Grammatikakis J, Evaggelinakis N, Kassanos D

3rd Department of Obstetrics and Gynecology, University of Athens, Attiko hospital, Athens, Greece

Correspondence: Evaggelinakis N, 3rd Department of Obstetrics and Gynecology, University of Athens, Attiko hospital, 1 Rimini St, GR-12464, Αthens, Greece.

 


 

Abstract

Acute viral hepatitis is the most common cause of jaundice in pregnancy. Chronic hepatitis B or D infections may be transmitted to the neonate. However, hepatitis B virus transmission is effectively prevented with perinatal hepatitis B vaccination and prophylaxis with hepatitis B immune globulin. Cholelithiasis occurs in 6% of pregnancies. Complications can be safely treated with surgery. Women with chronic liver disease or cirrhosis exhibit a higher risk of fetal loss during pregnancy. Preeclampsia is associated with HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome, acute fatty liver of pregnancy and hepatic infarction and rupture. Treatment involves prompt delivery, whereupon the liver disease quickly reverses. Therapy with penicillamine, trientine, prednisone or azathioprine can be safely continued during pregnancy.

Key words: liver disease; pregnancy; diagnosis; treatment