Pregnancy-related liver illness might be difficult for doctors to treat. Pregnancy is connected with a number of liver problems, although not all of them. Hyperemesis gravidarum, acute fatty liver of pregnancy (AFLP), intrahepatic cholestasis of pregnancy (ICP), and hemolysis and high liver enzymes and low platelets (HELLP) syndrome are some of the liver illnesses that are specific to pregnancy. It is possible for a pregnant woman to have acute viral hepatitis, and it is possible for a pregnant woman to develop chronic liver disease, including cirrhosis and portal hypertension.
The American College of Gastroenterology (ACG) recommends that pregnant women with abnormal liver tests undergo the same standard workup as nonpregnant individuals. For imaging investigations and endoscopies in pregnant women, the American College of Gastroenterology (ACG) recommends the following.:
- In the case of abnormal liver investigations that signal biliary tract illness, ultrasonography is the preferable imaging modality.
- In the second and third trimester, gadolinium-enhanced MRI may be employed.
- Teratogenesis and pediatric blood cancers may occur during CT scans, although they can be avoided if radiation procedures are followed wisely (2-5 rads).
- Pregnancy endoscopy is safe; however, it is best avoided until the second trimester.
- Endoscopic sedation may be achieved with meperidine and propofol.
The most prevalent cause of jaundice during pregnancy is acute viral hepatitis. Hepatitis E and disseminated herpes simplex infections, which raise maternal and foetal death rates, do not impact the course of acute hepatitis during pregnancy. Preventing the transmission of chronic hepatitis B or C infections to neonates is possible with hepatitis B vaccination and the use of hepatitis B immune globulin prophylaxis. When difficulties arise, surgery is safe and effective. Cholelithiasis occurs in around 6% of pregnancies. Pregnant women with chronic liver disease or cirrhosis are more likely to lose a foetus than those who are healthy. When preeclampsia is present, the HELLP syndrome, acute fatty liver, and hepatic infarctions and ruptures are all linked to preeclampsia. Premature maternal and foetal deaths are associated with several uncommon disorders. The liver condition is rapidly reversed if treatment is delivered soon. It is safe to administer penicillamine, trientine or prednisone during pregnancy.
