Management of liver disease during pregnancy
Keywords:
Liver, pregnancy, mortality, morbidity, complicationsAbstract
Background: Several liver diseases can be observed during pregnancy. Some are proper to pregnancy and others are not.
Aim: To study and to analyze the different liver diseases encountered during pregnancy and describe their management.
Methods: Retrospective study of 97 patients having a liver disease during their pregnancy, the cases were managed in the department "C" of obstetrics and newborn of Tunis.
Results: The prevalence of hepatopathy associated to pregnancy was 1.61 in our study. The mean term was 35 weeks of amenorrhea. 45% of labors were induced prematurily. 21 patients were transferred to intensive care unit after delivery due to the severity of their pathology. No maternal death was noted.
Conclusion: The better comprehension of physiopathology of this association can help to improve the patients care.
Downloads
References
Suivi et orientation des femmes enceintes en fonction des situations a risque identifiees, HAS, 2007. (en France)
Benjaminov FS, Heathcote J. Liver disease in pregnancy. Am J Gastroenterol 2004; 99: 2479-88.
Ismail SK, Kenny L. Review on hyperemesis gravidarum. Best Pract Res Clin Gastroenterol 2007; 21:755-69.
Bacq Y, Zarka O. Le foie au cours de la grossesse normale. Gastroenterol Clin Biol 1994; 18:767-74.
Bacq Y, Zarka O, Brechot J-F et al. Liver Function tests in normal pregnancy: a prospective study of 103 pregnant women and 103 matched controls. Hepatology 1996; 23: 1030-4.
Bacq Y. Intrahepatic cholestasis of pregnancy. Clin Liver Dis 1999; 3:1-313.
BacqY. Hépatopathies au cours de la grossesse. Gastroenterol Clin Biol 2001;25:791-8.
Heinonen S, Kirkinen P. Pregnancy outcome with intra hepatic cholestasis. Obstet Gynecol 1999; 94:189-93.
Estève E. Conduite à tenir devant un prurit de la femme enceinte.Ann Dermatol Venereol 1999; 126:634-8.
Chazouilleres O, Bacq Y. The liver and pregnancy. Gastroenterol Clin Biol 2004; 28:84-91.
Pottecher T. Réanimation des formes graves de pré-éclampsie. J Gynecol Obstet Biol Reprod 2001; 30:121-32.
Saphier CJ, Repke JT. Hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP): a review of diagnosis and management. Semin Perinatol 1998; 22:118-33.
Ibdah JA. Acute fatty liver of pregnancy: an update on pathogenesis and clinical implications. World J Gastroenterol 2006; 12:7397-404.
Uchikova E.H., Ledjev I. Changes in haemostasis during normal pregnancy, Eur. J. Obstet. Gynecol. Reprod. Biol. 2005; 2 :185- 188.
Fesenmeier MF, Coppage KH, Lambers DS et al. Acute fatty liver of pregnancy in three tertiary care centers. Am J Obstet Gynecol 2005; 192: 1416-9.
Bacq Y. La stéatose hépatique aiguë gravidique. Gastroenterol Clin Biol 1997;21:109-15.
Ch'ng CL, MorganM, Hainsworth I et al. Prospective study of liver dysfunction in pregnancy in Southwest Wales. Gut 2002; 51:876- 80.
Cobey FC, Salem RR. A review of liver masses in pregnancy and a proposed algorithm for their diagnosis and management. Am J Surg 2004; 187: 181-91.
