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liver disease during pregnancy

Etiology: 1) 1st & second trimesters a) viral hepatitis: - most common cause of jaundice - clinical course same as in non-pregnant state except for hepatitis E which has a mortality of 10% during pregnancy - therapy is supportive b) drug-induced hepatotoxicity - acetaminophen toxicity c) gallstones d) hyperemesis gravidarum* (1st trimester) [1] 2) 3rd trimester - intrahepatic cholestasis of pregnancy* - gallstones - acute fatty liver of pregnancy* - HELLP syndrome* - pre-eclampsia* 3) all causes of liver disease during pregnancy can recur in in subsequent pregnancies [1] * liver disease unique to pregnancy [1]

Related

pre-eclampsia/eclampsia

Specific

fatty liver of pregnancy HELLP syndrome hyperemesis gravidarum intrahepatic cholestasis of pregnancy (obstetric cholestasis)

General

pregnancy disorder; obstetric disorder; pregnancy complication liver disease

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 16, 17. American College of Physicians, Philadelphia 1998, 2006, 2012, 2015
  2. Pan C, Perumalswami PV. Pregnancy-related liver diseases. Clin Liver Dis. 2011 Feb;15(1):199-208 PMID: 21112001
  3. Hay JE Liver disease in pregnancy. Hepatology. 2008 Mar;47(3):1067-76 PMID: 18265410
  4. Bacak SJ, Thornburg LL. Liver Failure in Pregnancy. Crit Care Clin. 2016 Jan;32(1):61-72. Review. PMID: 26600444