Harrison's Practice: Liver Disease in Pregnancy

Liver Disease in Pregnancy

Definition

Liver disease in pregnancy can occur in several settings:
- Preexisting liver disease that is worsened by the physiologic changes of pregnancy
  - Examples include chronic hepatitis and cirrhosis.
- New-onset liver disease that is not specific to pregnancy
  - Examples include acute viral hepatitis.
- New-onset systemic disease with hepatic manifestations exacerbated by pregnancy
  - Examples include Budd-Chiari syndrome.
- New-onset liver disease that is specific to pregnancy
  - Examples include:
    - Intrahepatic cholestasis of pregnancy: condition characterized by accumulation of bile acids in the liver with subsequent accumulation in plasma, causing pruritus and jaundice in the second or third trimester of pregnancy with spontaneous resolution within 2–3 weeks after delivery
    - Acute fatty liver of pregnancy (AFLP): rare, life-threatening complication of pregnancy that occurs in the second half of pregnancy, usually the third trimester, or immediately postpartum
    - HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelet count): liver derangement that is a variant of severe preeclampsia or eclampsia, occurring in last half of pregnancy (after 20 weeks gestational age)

Liver Disease in Pregnancy has been found in Harrison's Practice

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