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Approach to liver disease occurring during pregnancy

Richard H Lee, MD
Tram T Tran, MD
Section Editors
Keith D Lindor, MD
Charles J Lockwood, MD, MHCM
Deputy Editors
Anne C Travis, MD, MSc, FACG, AGAF
Vanessa A Barss, MD, FACOG


Hepatobiliary disease occurring in a pregnant woman poses a challenge for the consulting clinician. Hepatic abnormalities occurring during pregnancy require diagnosis in the context of expected physiologic changes. In addition, diagnostic and therapeutic decisions have to consider the implications for both the mother and the fetus.

The types and presentation of hepatobiliary disease during pregnancy are varied.

Some liver diseases or multisystem diseases with hepatic manifestations are specific to pregnancy. Examples of the former are intrahepatic cholestasis of pregnancy and acute fatty liver of pregnancy; examples of the latter are hyperemesis gravidarum and preeclampsia, which may be complicated by the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP). (See appropriate topic reviews).

Pregnancy-related physiologic changes may worsen the severity of, or predispose to hepatobiliary diseases that may also occur in nonpregnant women. Examples include cholelithiasis, thrombotic diseases (such as Budd-Chiari syndrome), and hepatitis E virus infection. (See "Intercurrent hepatobiliary disease during pregnancy".)

Some diseases are not related to pregnancy but can initially present during pregnancy (eg, acute viral hepatitis). (See "Intercurrent hepatobiliary disease during pregnancy".)


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Literature review current through: Sep 2016. | This topic last updated: Apr 16, 2015.
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