Liver pathology in pregnancy

Non-alcoholic fatty liver disease (NAFLD) is now the commonest liver pathology in the UK; however, relatively little is known about its course in pregnancy or the effect it has on maternal or fetal outcomes. Described here is a 24-year-old woman in her first pregnancy who presented with non-specific symptoms and raised alanine aminotransferase with ultrasonography of her liver showing changes of steatosis and suspicious for cirrhosis, leading to a diagnosis of NAFLD. The case illustrates the need for the clinician to have awareness of this increasingly prevalent condition and for multidisciplinary management.

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OBSTETRIC CHOLESTASIS

Fetal and Maternal Medicine Review ◽

10.1017/s0965539504001305 ◽

2004 ◽

Vol 15 (3) ◽

pp. 247-272 ◽

Cited By ~ 1

Author(s):

ANNA P KENYON ◽

ANDREW SHENNAN

Keyword(s):

Liver Function ◽

Maternal Morbidity ◽

Current Knowledge ◽

Abnormal Liver Function ◽

Liver Pathology ◽

Obstetric Outcome ◽

In Pregnancy

Obstetric cholestasis (OC) is defined as pruritus of onset in pregnancy in association with abnormal liver function in the absence of any other identifiable liver pathology which resolves on delivery. It may be associated with adverse obstetric outcome and significant maternal morbidity. The significance of the disease has only recently been appreciated, and our understanding of its pathophysiology is in its infancy. This article will describe our current knowledge of the disease and critically review the interventions proposed to improve obstetric outcome and maternal morbidity.

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OBSTETRIC CHOLESTASIS

Fetal and Maternal Medicine Review ◽

10.1017/s0965539509002393 ◽

2009 ◽

Vol 20 (2) ◽

pp. 119-142

Author(s):

ANNA P KENYON ◽

ANDREW SHENNAN

Keyword(s):

Liver Function ◽

Maternal Morbidity ◽

Abnormal Liver Function ◽

Liver Pathology ◽

Obstetric Outcome ◽

Pakistani Origin ◽

The Uk ◽

Twin Pregnancies ◽

Chilean Populations ◽

In Pregnancy

Obstetric cholestasis (OC) also known a intrahepatic cholestatsis of pregnancy (ICP) is defined as pruritus of onset in pregnancy in association with abnormal liver function in the absence of any other identifiable liver pathology which resolves on delivery. It may be associated with adverse obstetric outcome and significant maternal morbidity. In the UK the prevalence is thought to be 0.6–0.7%, with up to 39–41% of women with OC being of Indian or Pakistani origin. Higher prevalence is also observed in Scandinavia (2%) and Chile (4%), (especially women of Araucanian Indian descent 24%). The condition occurs more commonly amongst twin pregnancies (20–22%) and is more common in the winter months in both Scandinavian and Chilean populations. The condition may occur more frequently in those >35 years of age (25% of cases).

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