Liver disease in pregnancy |
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Authors: | Noel M Lee Carla W Brady |
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Institution: | Noel M Lee, Department of Medicine, Duke University Medical Center, Durham, NC 27710, United StatesCarla W Brady, Division of Gastroenterology, Duke University Medical Center, Durham, NC 27710, United States |
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Abstract: | Liver diseases in pregnancy may be categorized into liver disorders that occur only in the setting of pregnancy and liver diseases that occur coincidentally with pregnancy. Hyperemesis gravidarum, preeclampsia/eclampsia, syndrome of hemolysis, elevated liver tests and low platelets (HELLP), acute fatty liver of pregnancy, and intrahepatic cholestasis of pregnancy are pregnancy-specific disorders that may cause elevations in liver tests and hepatic dysfunction. Chronic liver diseases, including cholestatic liver disease, autoimmune hepatitis, Wilson disease, and viral hepatitis may also be seen in pregnancy. Management of liver disease in pregnancy requires collaboration between obstetricians and gastroenterologists/hepatologists. Treatment of pregnancy-specific liver disorders usually involves delivery of the fetus and supportive care, whereas management of chronic liver disease in pregnancy is directed toward optimizing control of the liver disorder. Cirrhosis in the setting of pregnancy is less commonly observed but offers unique challenges for patients and practitioners. This article reviews the epidemiology, pathophysiology, diagnosis, and management of liver diseases seen in pregnancy. |
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Keywords: | Liver disease Pregnancy Maternal outcome Fetal outcome Cesarean section Cholestasis Viral hepatitis |
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