scholarly journals Pregnancy-related liver pathology: hyperemesis gravidarum, cholestatic hepatosis of pregnancy, preeclampsia/eclampsia, HELLP-syndrome, acute fatty liver of pregnancy

2021 ◽  
Vol 1 ◽  
pp. 7-16
Author(s):  
О.V. Golyanovskiy ◽  
N.E.  Geints ◽  
V.V.  Mekhedko ◽  
S.V.  Frolov
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Pregnant Women ◽  
Liver Dysfunction ◽  
Hellp Syndrome ◽  
Liver Diseases ◽  
Hyperemesis Gravidarum ◽  
Late Pregnancy ◽  
Risk Groups ◽  
Acute Fatty Liver

Liver disease associated with pregnancy affects up to 3% of women and is a common cause of dysfunction during pregnancy. Severe liver dysfunction is associated with high rates of maternal and infant morbidity and mortality.Therefore, it is important to know about liver diseases the woman suffered before pregnancy in order to adequately manage the pregnancy and reduce the number of complications during delivery. Research and recent advances in medicine tend to improve the consequences, but so far they have not shown significant reduction of the maternal and perinatal morbidity rates against the background of this pathology. Liver diseases that are characteristic for pregnancy can be classified into those of early pregnancy (hyperemesis gravidarum) and those of late pregnancy (preeclampsia/eclampsia, intrahepatic cholestasis of pregnant women; hemolysis, increased activity of liver enzymes) HELLP-syndrome, acute fatty liver disease of pregnant women - AFLP, liver rupture / infarction).The results of modern studies used in the practice of medical care for pregnant women with concomitant pathology have significantly improved the pregnancy and delivery outcomes, but the number of complications among the mother and the fetus is still high. In this article, we offer an overview of liver diseases complicated by pregnancy with a detailed presentation of their aetiology, pathogenesis, diagnosis, and treatment. The risk groups of pregnant women with the potential possibility of liver dysfunction development have also been identified.

scholarly journals Liver diseases unique to pregnancy

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 337 ◽  
Author(s):  
Jūratė Kondrackienė ◽  
Limas Kupčinskas
Keyword(s):  
Fatty Liver ◽  
Liver Diseases ◽  
Hyperemesis Gravidarum ◽  
Correct Diagnosis ◽  
Late Pregnancy ◽  
First Trimester ◽  
Third Trimester ◽  
Liver Disorders ◽  
Elevated Liver Enzymes ◽  
Acute Fatty Liver

The aim of this review article is to improve knowledge of the liver disease in pregnancy. The article summarizes the results of own experience and the recent reviews of liver disorders unique to pregnancy. Abnormalities in liver tests occur in 3% of pregnancies with causes ranging from self-limiting to rapidly fatal. In Kaunas University of Medicine Hospital, a retrospective analysis disclosed a rate of 0.52% of liver diseases in 16252 pregnant women over a 5-year period. Several liver diseases occur only during pregnancy and are considered to be associated with the pregnant state. The liver disorders unique to pregnancy have characteristic clinical features and timing of onset. Hyperemesis gravidarum occurs in the first trimester, intrahepatic cholestasis of pregnancy in the second or third trimester, preeclampsia, HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, and acute fatty liver of pregnancy usually in the third trimester. The disorders of late pregnancy – preeclampsia, HELLP syndrome, and acute fatty liver of pregnancy – may progress to severe liver dysfunction. The correct diagnosis is critical, as any delay can result in morbidity or mortality of both the mother and fetus. Early delivery and advances in supportive management are the only available option for improving the prognosis.

Liver disease

2019 ◽  
pp. 367-384
Author(s):  
Nina Vodošek Hojs ◽  
Aftab Ala ◽  
Debasish Banerjee
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Hepatitis C ◽  
Fatty Liver ◽  
Viral Hepatitis ◽  
Liver Dysfunction ◽  
Fatty Liver Disease ◽  
Liver Diseases ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Cardiovascular disease in patients with liver disease, previously uncommon, is rising because of an increasing incidence of non-alcoholic fatty liver disease and better survival of patients with viral hepatitis, particularly hepatitis C. Liver dysfunction alters the pharmacokinetics and pharmacodynamics of many drugs, and hence careful use and dose adjustments are necessary. This chapter describes common cardiovascular conditions and the pharmacotherapy in patients with different liver diseases.

scholarly journals Risk factors of maternal death in preeclampsia

2021 ◽  
Vol 6 (1) ◽  
pp. 27-31
Author(s):  
S. D. Babazhanova ◽  
A. S. Lyubchich ◽  
Yu. K. Jabbarova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Fatty Liver ◽  
Pregnant Women ◽  
Maternal Death ◽  
Hellp Syndrome ◽  
Premature Births ◽  
Maternal Deaths ◽  
Acute Fatty Liver ◽  
Insufficient Knowledge

Aim. To determine the factors contributing to maternal death due to preeclampsia.Materials and Methods. We performed a retrospective study of 149 maternal deaths from preeclampsia during 2013-2017, which included the analysis of birth histories, medical records, individual observation cards, outpatient records, and questionnaires of healthcare workers and relatives.Results. Preeclampsia was responsible for 24.1% of maternal deaths over 5 years (2013-2017). The causes of death in women with preeclampsia were: pulmonary oedema (33/149, 22.2% cases), acute renal failure (33/149, 22.2%), cerebral complications (43/149, 28.6%), and hepatic impairment (acute fatty liver of pregnancy or HELLP syndrome, 45/149, 30.2%). The majority of pregnant women admitted in critical condition because of acute fatty liver of pregnancy or HELLP syndrome (45/149, 30.2%), eclampsia at home (25/149, 16.8%), or severe hypertension (114/149, 76.5%). The majority of those who died from preeclampsia had premature births (86/149, 57.7%) and delivered by caesarean section (117, 78.5%), yet the latter was associated with a higher risk of maternal death in case of preeclampsia (OR = 30.028. 95% CI = 15.277-59.022) as compared with vaginal delivery. Risk factors of the maternal death in preeclampsia included late hospitalization (66% of deaths), inadequate antenatal care (64.4%), incorrect route of examination and hospitalization (31.6%), underestimation of the patient's condition (42.3 %), insufficient monitoring during pregnancy, childbirth and post childbirth (48.8%), and insufficient teamwork of medical staff (42.2%).Conclusions. Insufficient knowledge of preeclampsia symptoms by pregnant women and their families, insufficient monitoring of blood pressure, underestimation of organ dysfunction, late hospital admission, late delivery, insufficient antihypertensive therapy, delivery at elevated blood pressure, and insufficient teamwork of healthcare professionals increase the risk of maternal mortality in the patients with preeclampsia.

scholarly journals A study of spectrum and outcome of liver diseases in pregnant women at BRD medical college

2017 ◽  
Vol 6 (8) ◽  
pp. 3641
Author(s):  
Amrita Tiwari ◽  
Vani Aditya ◽  
Reena Srivastava ◽  
Geeta Gupta
Keyword(s):  
Liver Disease ◽  
Pregnant Women ◽  
Hyperemesis Gravidarum ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Medical College ◽  
Acute Fatty Liver ◽  
One Year ◽  
Labour Room ◽  
In Pregnancy

Background: Different spectrum of liver disease can affect outcome of pregnancy. The incidence of liver disorders in pregnancy varies in different parts of the world. The present study was designed to see the incidence, spectrum, and outcome of liver disease in pregnancy.Methods: All pregnant women with deranged liver profile, attending antenatal clinic and labour room in the department of Obstetrics and Gynecology of BRD Medical College over the period of one year (August 2015 to July 2016) were included in the study. Enrolled cases were followed up till discharge in respect to maternal and fetal outcome.Results: Liver disease was found in 214 (2.37%) cases out of 9011 pregnancies. Pregnancy specific liver disease was the most common type (85.98%). Among pregnancy specific liver disease Hypertensive disorders of pregnancy was the commonest abnormality (66.35%). Rest were Cholestasis, Acute viral hepatitis, Chronic liver disease, Hyperemesis gravidarum, Acute fatty liver of pregnancy. Out of 214, 22 patients dropped out. Overall maternal and perinatal mortality were 13.02% and 29.17% respectively.Conclusions: Liver disease in pregnancy is not uncommon and it can seriously affect pregnancy outcome if not treated properly on time. Early diagnosis (by clinical suspicion and blood investigation) and timely intervention can improve maternal and fetal outcome in pregnancy with liver disease.

Liver disease

2019 ◽  
pp. 367-384
Author(s):  
Nina Hojs ◽  
Aftab Ala ◽  
Debasish Banerjee
Keyword(s):  
Cardiovascular Disease ◽  
Liver Disease ◽  
Hepatitis C ◽  
Fatty Liver ◽  
Viral Hepatitis ◽  
Liver Dysfunction ◽  
Fatty Liver Disease ◽  
Liver Diseases ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Cardiovascular disease in patients with liver disease, previously uncommon, is rising because of an increasing incidence of non-alcoholic fatty liver disease and better survival of patients with viral hepatitis, particularly hepatitis C. Liver dysfunction alters the pharmacokinetics and pharmacodynamics of many drugs, and hence careful use and dose adjustments are necessary. This chapter describes common cardiovascular conditions and the pharmacotherapy in patients with different liver diseases.

scholarly journals ACUTE FATTY LIVER OF PREGNANCY MASQUERADING AS HELLP SYNDROME

2018 ◽  
Vol 5 (20) ◽  
pp. 1592-1595
Author(s):  
Santhosh Narayanan ◽  
Divya Prakash ◽  
Gomathy Subramaniam ◽  
Lakshminarayanan Lakshminarayanan
Keyword(s):  
Fatty Liver ◽  
Hellp Syndrome ◽  
Acute Fatty Liver

scholarly journals Comparison of Maternal and Neonatal Outcomes between Acute Fatty Liver of Pregnancy and Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Sau Xiong Ang ◽  
Chie-Pein Chen ◽  
Fang-Ju Sun ◽  
Chen-Yu Chen
Keyword(s):  
Cohort Study ◽  
Fatty Liver ◽  
Retrospective Cohort Study ◽  
Hellp Syndrome ◽  
Retrospective Cohort ◽  
Liver Enzymes ◽  
Neonatal Outcomes ◽  
Elevated Liver Enzymes ◽  
Acute Fatty Liver ◽  
Maternal And Neonatal Outcomes

Abstract Background: Acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome are two uncommon disorders that mimic each other clinically, but are distinct pathophysiologically. This study aimed to compare maternal and neonatal outcomes between AFLP and HELLP syndrome.Methods: This retrospective cohort study was performed at a tertiary referral center in Taiwan between June 2004 and April 2020. We used the Swansea Criteria to diagnose AFLP, and the Tennessee Classification System to diagnose HELLP syndrome. Maternal characteristics, laboratory data, complications, and neonatal outcomes were analyzed.Results: During the study period, 21 women had AFLP and 80 women had HELLP syndrome. There was a higher rate of preeclampsia (95.0% versus 23.8%) in the HELLP syndrome group compared to the AFLP group. However, the AFLP group had more other maternal complications including jaundice (85.7% versus 13.8%), acute kidney injury (61.9% versus 15.0%), disseminated intravascular coagulopathy (66.7% versus 8.8%), and sepsis (47.6% versus 10.0%) compared to the HELLP syndrome group. Nevertheless, higher rates of small for gestational age neonates (57.1% versus 33.3%), neonatal respiratory distress syndrome (39.2% versus 8.3%) and neonatal sepsis (34.2% versus 12.5%) were noted in the HELLP syndrome group.Conclusions: AFLP is associated with a higher rate of multiple organ dysfunction in mothers, whereas HELLP syndrome is associated with a higher rate of neonatal morbidity.

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