Abstract

TORO, Luis Guillermo et al. Liver diseases and pregnancy. Rev Col Gastroenterol [online]. 2019, vol.34, n.4, pp.385-398. ISSN 0120-9957.  https://doi.org/10.22516/25007440.367.

Liver diseases develop in 3% to 5% of all gestations. Among the causes are: 1. Physiological changes of pregnancy. 2. Pre-existing liver diseases and conditions. The most common are cholestatic diseases such as primary biliary cholangitis and primary sclerosing cholangitis. Others include autoimmune hepatitis, Wilson’s disease, chronic viral hepatitis, cirrhosis of any etiology and histories of liver transplantation. 3. Liver disease acquired during pregnancy, especially viral hepatitis, drug-induced toxicity and hepatolithiasis. 4. Pregnancy-related liver diseases including hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, preeclampsia, HELLP syndrome and fatty liver of pregnancy.

Severity ranges from absence of symptoms to acute liver failure and even death. Severe cases have significant morbidity and mortality for both mother and fetus. These cases require rapid evaluation, accurate diagnosis and appropriate management by a multidisciplinary team including high-risk obstetrics, hepatology, gastroenterology and interventional radiology. Availability of liver transplantation is also important for obtaining good outcomes.

Keywords : Pregnancy; hyperemesis gravidarum; gestational cholestasis; HELLP; preeclampsia; hepatitis B virus; cirrhosis; liver transplantation.

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