Pregnancy-related liver disorders

J Clin Exp Hepatol. 2014 Jun;4(2):151-62. doi: 10.1016/j.jceh.2013.03.220. Epub 2013 Mar 16.

Abstract

Pregnancy-related liver disorders accounted for 8% of all maternal deaths at our center from 1999 to 2011. Of the three pregnancy-related liver disorders (acute fatty liver of pregnancy (AFLP), HELLP (Hemolysis, elevated liver enzymes, low platelets) syndrome and pre-eclamptic liver dysfunction, which can lead to adverse maternal and fetal outcome, AFLP is most typically under - diagnosed. Risk of maternal death can be minimised by timely recognition and early/aggressive multi-specialty management of these conditions. Urgent termination of pregnancy remains the cornerstone of therapy for some of these life threatening disorders, but recent advancements in our understanding help us in better overall management of these patients. This review focuses on various aspects of pregnancy-related liver disorders.

Keywords: AFLP, acute fatty liver of pregnancy; CS, Caesarean; FAO, fatty acid oxidation; HELLP syndrome; HELLP, hemolysis elevated liver enzymes and low platelets; HG, hyperemesis gravidarum; HbsAg, hepatitis B surface antigen; ICP, intrahepatic cholestasis of pregnancy; LCHAD, long chain hydroxyacyl coA dehydrogenase; LDH, lactate dehydrogenase; LFT, liver function tests; MP, malarial parasite; MTP, mitochondrial tri-functional protein; PFIC, progressive familial intra-hepatic cholestasis; PRLD, pregnancy-related liver disorders; PT, prothrombin time; UDCA, ursodeoxycholic acid; acute fatty liver of pregnancy; maternal mortality; pre-eclampsia.

Publication types

  • Review