Lebererkrankungen in der Schwangerschaft

A complete spectrum of maternal liver diseases occurs during pregnancy. Many, such as viral hepatitis, are not related to pregnancy. In contrast, women may develop potentially life-threatening liver diseases uniquely related to pregnancy. Beside the syndrome of Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP syndrome), these include the common intrahepatic cholestasis of pregnancy and the very rare acute fatty liver of pregnancy. During the past decade the molecular pathogenesis of these two diseases has been better defined, and mutations in genes encoding the hepatocanalicular phospholipid transporter and enzymes of fatty acid β-oxidation have been identified as genetic risk factors. Furthermore, due to optimized obstetric, intensive care and hepatological management, maternal and fetal mortality have decreased significantly.