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[Abnormal liver tests during pregnancy - emergency department decision making]
Caroline Boonekamp1, Christophe Fehlmann1,2
1Service de médecine interne générale, Département de médecine interne, réhabilitation et gériatrie, HUG, 1211 Genève 14.
Revue Medicale Suisse
|August 10, 2018
Summary
Abnormal liver function tests in pregnant women can indicate serious conditions like HELPPS syndrome or acute fatty liver of pregnancy. Emergency physicians must distinguish these from minor issues and non-pregnancy related liver diseases.
Area of Science:
- Emergency Medicine
- Hepatology
- Obstetrics
Background:
- Abnormal liver function tests are common in emergency departments.
- Pregnancy-related liver conditions can pose life-threatening risks to both mother and fetus.
- Differentiating liver pathologies is crucial for timely and appropriate management.
Purpose of the Study:
- To outline the emergency physician's role in evaluating abnormal liver tests in pregnant patients.
- To differentiate serious from minor pregnancy-related liver diseases.
- To recognize non-pregnancy related liver diseases presenting in pregnant women.
Main Methods:
- Clinical review of common and critical liver diseases in pregnancy.
- Categorization of pregnancy-related liver conditions based on severity.
- Emphasis on diagnostic differentiation in the emergency setting.
Main Results:
- Key pregnancy-related liver diseases include HELPPS syndrome, pre-eclampsia/eclampsia, and acute fatty liver of pregnancy (serious).
- Minor pregnancy-related liver conditions include intrahepatic cholestasis and hyperemesis gravidarum.
- Emergency physicians must also consider and identify non-pregnancy related liver diseases.
Conclusions:
- Prompt and accurate diagnosis of liver abnormalities in pregnancy is vital for maternal and fetal outcomes.
- Emergency physicians play a critical role in the initial assessment and triage of these patients.
- A systematic approach is necessary to manage diverse liver pathologies in pregnant women.
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