Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study

Vásquez, Daniela N.; Neves, Andrea V. Das; Aphalo, Vanina M.; Vidal, Laura; Moseinco, Miriam; Lapadula, Jorge; Santamaría, Analía; Zakalik, Graciela; Gómez, Raúl; Capalbo, Mónica; Fernandez, Claudia; Agüero-Villareal, Enrique; Vommaro, Santiago; Moretti, Marcelo S.; Soli, Silvana B.; Ballestero, Florencia; Sottile, Juan P.; Chapier, Viviana; Lovesio, Carlos; Santos, José; Bertoletti, Fernando; Mos, Fernando A; Risso-Vázquez, Alejandro; Esteban-Chacon, Mercedes; Illutovich, Santiago; Chapela, Sebastián Pablo; Loudet, Cecilia; Scapellato, José Luis; Intile, Alfredo D.; Bakker, Jan

doi:10.1080/10641955.2021.1981373

Cited by 1 publication

(1 citation statement)

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“…From a prognostic point of view, elevated liver enzymes are an important and independent risk factor for the development of unfavorable maternal outcomes [ 62 , 72 , 73 ]. Therefore, transaminases are included in most of the scores used in clinical practice to stratify for the risk of maternal complications in patients with PE, such as PREP-S [ 74 ] and fullPIERS [ 75 ].…”

Section: Pregnancy-related Liver Disordersmentioning

confidence: 99%

Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review

Dajti,

Bruni,

Barbara

et al. 2023

JPM

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Liver disease is not uncommon during pregnancy and is associated with increased maternal and fetal/neonatal morbidity and mortality. Physiological changes during pregnancy, including a hyperestrogenic state, increase in circulating plasma volume and/or reduction in splanchnic vascular resistance, and hemostatic imbalance, may mimic or worsen liver disease. For the clinician, it is important to distinguish among the first presentation or exacerbation of chronic liver disease, acute liver disease non-specific to pregnancy, and pregnancy-specific liver disease. This last group classically includes conditions such as hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, liver disorders associated with the pre-eclampsia spectrum, and an acute fatty liver of pregnancy. All of these disorders often share pathophysiological mechanisms, symptoms, and laboratory findings (such as elevated liver enzymes), but a prompt and correct diagnosis is fundamental to guide obstetric conduct, reduce morbidity and mortality, and inform upon the risk of recurrence or development of other chronic diseases later on in life. Finally, the cause of elevated liver enzymes during pregnancy is unclear in up to 30–40% of the cases, and yet, little is known on the causes and mechanisms underlying these alterations, or whether these findings are associated with worse maternal/fetal outcomes. In this narrative review, we aimed to summarize pragmatically the diagnostic work-up and the management of subjects with elevated liver enzymes during pregnancy.

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