Feature Article

Abnormal liver function test results in pregnancy – causes and management



© peopLeimAGes/isTocKpHoTo.com
© peopLeimAGes/isTocKpHoTo.com


It is common in pregnancy for patients to have abnormal liver function test results, and both pre-existing and unique pregnancy-related liver disorders need to be considered as a cause. Diagnosis and management require a systematic approach, with some of these conditions being associated with serious maternal and perinatal outcomes. The continued collaboration between the GP, obstetrician and gastroenterologist is crucial to ensuring good outcomes for mothers and their babies.

Key Points

  • The normal ranges for several liver function tests are different for pregnant patients compared with non-pregnant patients.
  • An increase in serum alkaline phosphatase level is usually physiological; however, any rise in bilirubin or aminotransferase levels should be investigated.
  • Both pregnancy-specific and primary liver pathologies need to be considered.
  • Pre-eclampsia, HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome, acute fatty liver of pregnancy and intrahepatic cholestasis of pregnancy can have associated perinatal morbidity and mortality.
  • Blood tests and imaging are recommended to assist with diagnosis.