Pregnancy-Associated Liver Diseases

Terrault, Norah A.; Williamson, Catherine

doi:10.1053/j.gastro.2022.01.060

Cited by 29 publications

(48 citation statements)

References 197 publications

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“…

We read the accurate and interesting review on liver diseases and pregnancy by Terrault and Williamson. 1 The investigators highlight 5 liver disorders that are unique to pregnancy. In their introduction Q4 , they describe in detail non-pregnancy-specific liver diseases at their first presentation during pregnancy and acute liver insufficiency, which is coincidental but not specific to pregnancy, and finally discuss clinical conditions that are associated with physiologic changes that mimic liver disease.

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mentioning

confidence: 99%

Bile and Liver in Pregnancy: No One Split Apart What God Has Joined Together

Maringhini¹,

Maringhini²

2023

Gastroenterology

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confidence: 99%

Bile and Liver in Pregnancy: No One Split Apart What God Has Joined Together

Maringhini¹,

Maringhini²

2023

Gastroenterology

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“…´ la evaluación clínica y el abordaje multidisciplinario, son fundamentales para garantizar una atención adecuada y minimizar los riesgos. (11).…”

Section: Resultsunclassified

“…Los trastornos hipertensivos del embarazo son una de las principales causas de mortalidad materna y perinatal (11). La preeclampsia complica del 2 -8 % de los embarazos, siendo la complicación más frecuente en este período, constituyendo el 25 % de las complicaciones maternas graves, incluida la muerte (2,11). En Estados Unidos, la tasa de preeclampsia aumentó un 25 % (11).…”

Section: Preeclampsiaunclassified

“…La preeclampsia complica del 2 -8 % de los embarazos, siendo la complicación más frecuente en este período, constituyendo el 25 % de las complicaciones maternas graves, incluida la muerte (2,11). En Estados Unidos, la tasa de preeclampsia aumentó un 25 % (11). En Colombia es la principal causa de morbilidad y mortalidad materna y es más común en países de medianos y bajos ingresos.…”

Section: Preeclampsiaunclassified

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Ruptura hepática espontánea en el síndrome de HELLP. Una revisión de la literatura

Alcívar

Pino

2022

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Introducción: El síndrome HELLP afecta hasta el 20 % de las gestantes con preeclampsia y está asociado con altas tasas de mortalidad materna y fetal. La ruptura hepática espontánea es una complicación potencialmente mortal del síndrome HELLP, afecta a 1 de cada 45,000 - 260,000 gestaciones, principalmente multíparas; en los 40 años; después de las 32 semanas de gestación. Objetivo: Realizar una revisión narrativa de la literatura actual sobre la ruptura hepática espontánea asociada al síndrome de HELLP. Metodología: Se realizó una revisión bibliográfica de publicaciones científicas afines al objetivo de la revisión en las bases de datos electrónicas de Pubmed, Redalyc, ScienceDirect, SciELO. Resultados: La rotura hepática es la rotura de un hematoma subcapsular hepático compresivo, estos hematomas suelen presentarse en 5 de cada 7 mujeres con preeclampsia severa o síndrome de HELLP. Fisiopatológicamente los depósitos de fibrina y el vasoespasmo en el embarazo conllevan al aumento de la presión hepática y necrosis, provocando la ruptura hepática. Las manifestaciones clínicas incluyen dolor en el cuadrante superior derecho, dolor epigástrico, vómitos y shock hemodinámico. Suele ser diagnosticado a partir del hallazgo quirúrgico asociado a lesión y riesgo materno y/o fetal. Los enfoques terapéuticos van desde el manejo conservador hasta el trasplante hepático. Conclusiones: La ruptura hepática espontánea de un hematoma hepático subcapsular originada por el síndrome de HELLP es una complicación poco frecuente pero potencialmente mortal, que por lo general se presenta entre las semanas 28 y 36 de gestación. Las manifestaciones clínicas incluyen dolor epigástrico, dolor en el cuadrante derecho repentino y shock hemodinámico. Si se sospecha de la ruptura, los exámenes complementarios incluyen el ultrasonido. El tratamiento puede consistir desde el manejo conservador, laparotomía de emergencia, embolización arterial hasta el trasplante de hígado.

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“…Intrahepatic cholestasis of pregnancy (ICP) was determined by pruritus occurring during pregnancy and serum TBA above 10 µmol/L, and excluding for elevated serum aminotransferase and/or serum bile acids related to other causes of liver test abnormalities 25,26 . ICP has been reported to be related to maternal and fetal diseases during pregnancy, such as PE, gestational diabetes mellitus (GDM) 27 , placental abnormalities 28 and stillbirth 29 .…”

Section: Commentmentioning

confidence: 99%

The association of serum total bile acid with new-onset hypertension during pregnancy

Deng

Zhang

et al. 2022

Preprint

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Background: There has been considerable interest in the interrelationship between the liver and hypertension. The relationship between serum total bile acid (TBA) and hypertension has been reported. Moreover, intrahepatic cholestasis of pregnancy was correlated to gestation hypertension. However, the association between maternal serum TBA level in the normal range and new-onset hypertension disorders during pregnancy remains unclear. To evaluate the relationship between maternal serum TBA level in the normal range and the risk, disease severity and adverse pregnancy outcomes of new-onset hypertension during pregnancy.Method: Using the electronic medical records on all pregnant women from the Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, between 2014 and 2020, we conducted a retrospective cohort study of 2581 singleton pregnant women with maternal serum TBA levels in the normal range. Patients were grouped into the non-hypertension during pregnancy (1071), gestational hypertension (480) and preeclampsia (1030) groups. Result: We found that maternal serum TBA levels were significantly higher in the preeclampsia and gestational hypertension groups than in the non-hypertension group (p<0.01). Multiple logistic regression analysis showed that TBA level was independently and significantly associated with preeclampsia and gestational hypertension (odds ratio: 1.37, 95% confidence interval [CI]: 1.27-1.48, p=0.001, odds ratio: 1.34, 95% confidence interval [CI]: 1.24-1.46, p=0.005, respectively). Moreover, elevated TBA level was positively associated with the risk of severe PE and negatively with mild PE (p<0.01). In addition, maternal serum TBA levels were negatively related to birth weight (p < 0.001).Conclusions: These results suggest that maternal serum TBA in the normal range also might be a valuable biomarker for disease severity in preeclampsia and gestational hypertension. Additionally, our results also indicate associations of serum total bile acid levels in the normal range with an increased risk of intrauterine growth restriction and low birth weight among offspring. These results suggest that TBA could serve as a prognostic biomarker for new-onset hypertension during pregnancy.

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Pregnancy-Associated Liver Diseases

Cited by 29 publications

References 197 publications

Bile and Liver in Pregnancy: No One Split Apart What God Has Joined Together

Bile and Liver in Pregnancy: No One Split Apart What God Has Joined Together

Ruptura hepática espontánea en el síndrome de HELLP. Una revisión de la literatura

The association of serum total bile acid with new-onset hypertension during pregnancy

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