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Liver diseases unique to pregnancy: a 2010 update.
Clin Res Hepatol Gastroenterol. 2011 Mar; 35(3):182-93.CR

Abstract

Liver disorders occurring during pregnancy may be specifically pregnancy-related, or may be due to an intercurrent or chronic liver disease, which may present in anyone, pregnant or not. This review focuses on the liver diseases unique to pregnancy. Hyperemesis gravidarum, which occurs during early pregnancy, may be associated with liver dysfunction. Intrahepatic cholestasis of pregnancy typically occurs during the second or third trimester. Pruritus and the associated biological signs of cholestasis improve rapidly after delivery. Mutations in gene encoding biliary transporters, especially ABCB4 encoding the multidrug resistance 3 protein, have been found to be associated with this complex disease. Ursodeoxycholic acid is currently the most effective medical treatment in improving pruritus and liver tests. Pre-eclampsia, which presents in late pregnancy frequently involves the liver, and HELLP syndrome (Hemolysis-Elevated Liver enzymes-Low Platelets) is a life-threatening complication. Prognosis of acute fatty liver of pregnancy has been radically transformed by early delivery, and clinicians must have a high index of suspicion for this condition when a woman presents nausea or vomiting, epigastric pain, jaundice, or polyuria-polydipsia during the third trimester. Acute fatty liver of pregnancy has been found to be associated with a defect of long-chain 3-hydroxyacyl coenzyme A dehydrogenase in the fetus, and mothers and their offspring should undergo DNA testing at least for the main associated genetic mutation (c.1528G>C).

Authors+Show Affiliations

Service d'hépatogastro-entérologie, hôpital Trousseau, Tours cedex, France. patrice.andre@inserm.fr

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

21310683

Citation

Bacq, Yannick. "Liver Diseases Unique to Pregnancy: a 2010 Update." Clinics and Research in Hepatology and Gastroenterology, vol. 35, no. 3, 2011, pp. 182-93.
Bacq Y. Liver diseases unique to pregnancy: a 2010 update. Clin Res Hepatol Gastroenterol. 2011;35(3):182-93.
Bacq, Y. (2011). Liver diseases unique to pregnancy: a 2010 update. Clinics and Research in Hepatology and Gastroenterology, 35(3), 182-93. https://doi.org/10.1016/j.clinre.2010.11.011
Bacq Y. Liver Diseases Unique to Pregnancy: a 2010 Update. Clin Res Hepatol Gastroenterol. 2011;35(3):182-93. PubMed PMID: 21310683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Liver diseases unique to pregnancy: a 2010 update. A1 - Bacq,Yannick, PY - 2010/08/09/received PY - 2010/11/19/revised PY - 2010/11/23/accepted PY - 2011/2/12/entrez PY - 2011/2/12/pubmed PY - 2011/9/2/medline SP - 182 EP - 93 JF - Clinics and research in hepatology and gastroenterology JO - Clin Res Hepatol Gastroenterol VL - 35 IS - 3 N2 - Liver disorders occurring during pregnancy may be specifically pregnancy-related, or may be due to an intercurrent or chronic liver disease, which may present in anyone, pregnant or not. This review focuses on the liver diseases unique to pregnancy. Hyperemesis gravidarum, which occurs during early pregnancy, may be associated with liver dysfunction. Intrahepatic cholestasis of pregnancy typically occurs during the second or third trimester. Pruritus and the associated biological signs of cholestasis improve rapidly after delivery. Mutations in gene encoding biliary transporters, especially ABCB4 encoding the multidrug resistance 3 protein, have been found to be associated with this complex disease. Ursodeoxycholic acid is currently the most effective medical treatment in improving pruritus and liver tests. Pre-eclampsia, which presents in late pregnancy frequently involves the liver, and HELLP syndrome (Hemolysis-Elevated Liver enzymes-Low Platelets) is a life-threatening complication. Prognosis of acute fatty liver of pregnancy has been radically transformed by early delivery, and clinicians must have a high index of suspicion for this condition when a woman presents nausea or vomiting, epigastric pain, jaundice, or polyuria-polydipsia during the third trimester. Acute fatty liver of pregnancy has been found to be associated with a defect of long-chain 3-hydroxyacyl coenzyme A dehydrogenase in the fetus, and mothers and their offspring should undergo DNA testing at least for the main associated genetic mutation (c.1528G>C). SN - 2210-741X UR - https://www.unboundmedicine.com/medline/citation/21310683/Liver_diseases_unique_to_pregnancy:_a_2010_update_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2210-7401(11)00003-9 DB - PRIME DP - Unbound Medicine ER -