Liver biochemistry results can be abnormal due to changes that occur during pregnancy. Careful history taking and examination are required to establish the cause and, if a hepatobiliary disorder is present, to determine whether it is pre-existing, coincidental or related to the pregnancy.
- Liver disease is not uncommon during pregnancy and it may be pre-existing, coincidental or pregnancy related.
- The patient’s clinical history and stage of pregnancy will help to determine the likely cause of abnormal liver biochemistry.
- Pregnancy-related liver diseases include hyperemesis gravidarum, pre-eclampsia, intrahepatic cholestasis of pregnancy, HELLP syndrome and acute fatty liver of pregnancy; they can be life-threatening and may recur in subsequent pregnancies.
- Severe pre-eclampsia with hepatic involvement, HELLP syndrome and acute fatty liver of pregnancy are indications for delivery.
- Babies born to mothers positive for hepatitis B surface antigen (HBsAg) should be given a dose of monovalent hepatitis B vaccine and hepatitis B immunoglobulin at birth.
- Breastfeeding is generally safe for mothers with hepatitis B or C but should be avoided when the nipples are cracked and bleeding.
Picture credit: © Westend61/Miriam D/Diomedia.com