Liver Problems During Pregnancy
During pregnancy, complications due to liver can arise due to preexisting liver problems or new liver problems arising post pregnancy
. In the former category, there are some liver diseases that specific to only pregnancies. Failure of the liver in performing new functions can put a strain on the mothers body. Though there are treatments available, but the best cure is to deliver the baby.
The following liver diseases are specific to pregnancy:
Acute fatty liver-This disorder occurs during the third trimester (last three months) of the pregnancy and is accompanied by preeclampsia (high blood pressure during pregnancy). Symptoms of this disorder include nausea and vomiting, severe abdominal pain, increased urination and thirst, jaundice, lethargy, fatigue and change in the mental status. A lot of patients also experience acute renal failure. Lab findings show low blood sugar, low levels of platelets, increased liver enzymes and infiltration of fats in the liver.
Intrahepatic cholestasis of pregnancy This is a rare disorder that affects first time and second time mothers to be. This condition is characterized by pruritus and mild jaundice and it usually occurs during the last trimester of the pregnancy. In this condition, the bile flow gets affected resulting in accumulation of bile in the blood resulting in severe itching and in some rare cases, jaundice. One of the most common symptoms of this disorder includes severe itching on the bdy especially on the palms and soles. Other symptoms include dark urine, fatigue, loss of appetite, mild depression and nausea.
Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome- Also called as the HELLP syndrome, it occurs in the third trimester of pregnancy. It can also occur after delivery. This disorder usually occurs in women who have preeclampsia though it can also occur in women who do not have a history of high blood pressure. The signs and symptoms include epigastric pain, nausea, vomiting, headache, visual changes, weight gain, jaundice, pulmonary edema, ascites or acute renal failure
Hepatic rupture- The exact occurrence of hepatic rupture is not known, its occurrence has been associated with preeclampsia, eclampsia. Acute fatty live disease, HELLP syndrome, hepatocellular carcinoma, hepatic adenoma, hemangioma and hepatic abscess. Studies have shown that the involvement of right lobe of the liver is much more than the left lobe. The symptoms include nausea and vomiting, abdominal pain, abdominal distension and hypovolemic shock.
Portal hypertension- This has been described as an increase in the blood pressure in the portal vein system caused by obstruction in the liver resulting in enlargement of the spleen. This can happen due to alcoholic cirrhosis. The symptoms of this disorder include variceal hemorrhage, hepatic encephalopathy, postpartum hemorrhage, hepatic failure, rupture of splenorenal shunts, spontaneous bacterial peritonitis and death of the mother.
Viral hepatitis- This can occur in any trimester due to infection of hepatotropic viruses. The mother can suffer from hepatitis A, B,C,D and E.
Budd-Chiari Syndrome- This rare condition is induced by thrombotic and nonthrombotic obstruction to hepatic venous outflow. Many cases are associated with contraceptives. Symptoms of this disorder are usually acute with abdominal pain, hepatomegaly and ascites.
by: Victor Daniels
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