Liver diseases unique to pregnancy

Kondrackienė, Jūratė; Kupčinskas, L.

doi:10.3390/medicina44050044

Cited by 15 publications

(15 citation statements)

References 54 publications

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“…Pruritus, as the cardinal feature of ICP, helps distinguish it from other types of liver pregnancy-related disease that can share similar laboratory features (such as early HELLP syndrome, acute fatty liver of pregnancy or preeclampsia) [3,7,59] . In patients presenting with jaundice, choledocholithiasis should be excluded, and abdominal ultrasound is indicated in this situation.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…In Scandinavian and Baltic countries ICP occurs in up to 2% of pregnancies, while in other countries of Europe and North America the incidence is less than 1% [3][4][5] , and in South Asian populations the incidence is 0.8%-1.46% [6] . In Lithuania, a retrospective analysis disclosed a rate of 0.4% of ICP in 16 252 pregnant women over a period of five years [7] . The low incidence of ICP may reflect an underestimation of the problem, and growing awareness of the condition will probably increase the numbers [2] .…”

Section: Epidemiologymentioning

confidence: 99%

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Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems

Kondrackienė¹,

Kupčinskas²

2008

WJG

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Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder. Maternal effects of ICP are mild; however, there is a clear association between ICP and higher frequency of fetal distress, preterm delivery, and sudden intrauterine fetal death. The cause of ICP remains elusive, but there is evidence that mutations in genes encoding hepatobiliary transport proteins can predispose for the development of ICP. Recent data suggest that ursodeoxycholic acid is currently the most effective pharmacologic treatment, whereas obstetric management is still debated. Clinical trials are required to identify the most suitable monitoring modalities that can specifically predict poor perinatal outcome. This article aims to review current achievements and unsolved problems of ICP.

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Section: Differential Diagnosismentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems

Kondrackienė¹,

Kupčinskas²

2008

WJG

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“…Acute fatty liver of pregnancy and intrahepatic cholestasis of pregnancy are hepatic disorders specific to pregnancy with etiopathogenesis related to physiological changes of pregnancy [ 4 , 5 ]. Certain conditions related to pregnancy such as hyperemesis gravidarum, preeclampsia syndrome, and HELLP syndrome (hemolysis, elevated liver enzyme and low platelet count) cause hepatic dysfunction although the exact etiopathogenesis remains unclear [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Interventional radiological management of hepatobiliary disorders in pregnancy

Rana¹,

Gupta²,

Chaluvashetty³

et al. 2020

ceh

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“…So far, rapid delivery is often the only choice to prevent life-threatening complications in mother and child[ 10 ]. At present, obstetricians routinely monitor laboratory markers such as aspartate transaminase (AST), alanine transaminase (ALT) and gamma-glutamyltransferase (GGT).…”

Section: Introductionmentioning

confidence: 99%

Liver stiffness reversibly increases during pregnancy and independently predicts preeclampsia

Ammon¹,

Kohlhaas²,

Elshaarawy³

et al. 2018

WJG

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AIMTo study liver stiffness (LS) during pregnancy and its association with complications during pregnancy.METHODSIn this observational, diagnostic study, 537 pregnant women were prospectively enrolled at the Department of Obstetrics and Gynecology, University hospital Heidelberg and Salem Medical Center. LS was measured using the Fibroscan device (Echosens, Paris) in all women and in 41 cases 24 h after delivery. Clinical and morphological data were recorded and abdominal ultrasound and standard laboratory tests were performed. No complications were observed in 475 women (controls) while preeclampsia and intrahepatic cholestasis of pregnancy (ICP) developed in 22 and 40 women, respectively.RESULTSIn controls, LS increased significantly from initially 4.5 ± 1.2 kPa in the second trimester to 6.0 ± 2.3 kPa (P < 0.001) in the third trimester. In the third trimester, 41% of women had a LS higher than 6 kPa. Elevated LS in controls was significantly correlated with alkaline phosphatase, leukocytes, gestational age and an increase in body weight and body mass index (BMI). In women with pregnancy complications, LS was significantly higher as compared to controls (P < 0.0001). Moreover, in multivariate analysis, LS was an independent predictor for preeclampsia with an odds ratio of 2.05 (1.27-3.31) and a cut-off value of 7.6 kPa. In contrast, ICP could not be predicted by LS. Finally, LS rapidly decreased in all women within 24 h after delivery from 7.2 ± 3.3 kPa down to 4.9 ± 2.2 kPa (P < 0.001).CONCLUSIONDuring pregnancy, LS significantly and reversibly increases in the final trimester of pregnant women without complications. In women with preeclampsia, LS is significantly elevated and an independent non-invasive predictor.

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Liver diseases unique to pregnancy

Abstract: Summary. The aim of this review article is to improve knowledge of the liver disease in

Cited by 15 publications

References 54 publications

Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems

Intrahepatic cholestasis of pregnancy-current achievements and unsolved problems

Interventional radiological management of hepatobiliary disorders in pregnancy

Liver stiffness reversibly increases during pregnancy and independently predicts preeclampsia

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