[Liver diseases in pregnancy].

Area of Science:

• Obstetrics and Gynecology
• Hepatology
• Maternal-Fetal Medicine

Context:

• Abnormal liver function tests are observed in 3-5% of pregnancies.
• Liver diseases in pregnancy are categorized into preeclampsia-associated and non-associated types.
• Common pregnancy-related liver conditions include preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, hyperemesis gravidarum, and intrahepatic cholestasis of pregnancy.

Purpose:

• To classify and describe the spectrum of pregnancy-related liver diseases.
• To differentiate between liver conditions associated and not associated with preeclampsia.
• To highlight the clinical presentation, risks, and management of these conditions.

Summary:

• Preeclampsia-associated liver diseases include preeclampsia, HELLP syndrome, and acute fatty liver of pregnancy.
• Non-preeclampsia-associated liver diseases include hyperemesis gravidarum and intrahepatic cholestasis of pregnancy.
• Management strategies range from symptomatic treatment (e.g., ursodeoxycholic acid for intrahepatic cholestasis) to prompt delivery for severe conditions like preeclampsia, HELLP syndrome, and acute fatty liver of pregnancy.

Impact:

• Understanding these classifications aids in timely diagnosis and appropriate management of liver dysfunction during pregnancy.
• Recognizing severe conditions like acute fatty liver of pregnancy and HELLP syndrome is critical for preventing life-threatening maternal complications.
• Effective management strategies are essential for improving maternal and fetal outcomes in pregnancies complicated by liver disease.