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The microscopic anatomy of the liver is a complex and intricate system that comprises numerous structural units known as liver lobules, each of which is comparable in size to a sesame seed. These hexagonal structures consist of plates of liver cells or hepatocytes, which are characterized by their versatility and abundance of cellular apparatus like rough and smooth ER, Golgi apparatus, peroxisomes, and mitochondria.
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Related Experiment Video

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Liver pathology in pregnancy.

Jacqueline E Birkness-Gartman1, Kiyoko Oshima1

  • 1Department of Pathology, Division of Gastrointestinal/Liver Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Pathology International
|November 24, 2021
PubMed
Summary
This summary is machine-generated.

Pregnancy-associated liver conditions, including intrahepatic cholestasis of pregnancy (ICP) and acute fatty liver of pregnancy (AFLP), require careful management. Understanding their distinct features is crucial for maternal and fetal well-being.

Keywords:
acute fatty livercholestasiseclampsialiver diseasepregnancy

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Area of Science:

  • Hepatology
  • Obstetrics
  • Gastroenterology

Background:

  • Liver dysfunction affects up to 3% of pregnancies, stemming from pregnancy-associated liver injury, pre-existing conditions, or coincidental illnesses.
  • Key conditions include intrahepatic cholestasis of pregnancy (ICP), acute fatty liver of pregnancy (AFLP), and hypertensive disorders (pre-eclampsia, HELLP syndrome).

Purpose of the Study:

  • To review the pathophysiology, clinical presentation, histological features, and management strategies for various liver conditions occurring during pregnancy.
  • To differentiate between conditions like ICP, AFLP, and hypertensive disorders, highlighting their varying risks and diagnostic criteria.

Main Methods:

  • Review of existing literature on pregnancy-associated liver diseases.
  • Analysis of clinical, biochemical, and histological data for conditions such as ICP, AFLP, HELLP, hepatitis E, and liver masses.
  • Synthesis of diagnostic and management approaches.

Main Results:

  • ICP is common but usually benign, though high bile acids pose fetal risks.
  • AFLP and hypertensive disorders carry significant maternal and fetal risks, often requiring urgent delivery.
  • Other conditions like hyperemesis gravidarum, hepatitis E, Budd-Chiari syndrome, and liver masses present unique diagnostic and management challenges.

Conclusions:

  • Accurate diagnosis and timely management of pregnancy-associated liver conditions are vital for optimizing maternal and fetal outcomes.
  • Histological findings play a key role in differentiating between various liver pathologies in pregnancy.
  • This review provides a comprehensive overview to guide clinicians in managing these complex cases.