Selected liver diseases complicating pregnancy Zoulikha Jabiry-Zieniewicz, Bronisława Pietrzak, Anna Cyganek, Urszula Ołdakowska-Jedynak, Paweł Kamiński, Małgorzata Bińkowska, Mirosław Wielgoś Medical Science Review - Hepatologia 2005; 5 85-90 aaICID: 16119
IC™ Value: 1.86
Abstract provided by Publisher
I Katedra i Klinika Położnictwa i Ginekologii AM, Warszawa
Liver dysfunctions present in pregnancy due to hyperemesis and severe preeclampsia were discussed. Severe liver diseases complicate approximately 0.1% of all pregnancies. They may be dangerous for both mother and fetus. The frequency of hyperemesis is estimated as 0.5/1000 pregnancies, especially in case of twin or molar gestation as well as in nulliparous women. It seems to be a rather rare cause of liver dysfunction (16–33% of cases). Persistent emesis in early pregnancy associated with hydro-electrolytic disorders and starvation may lead to severe complications, such as dehydration with orthostatic hypotonia and tachycardia, weight loss, ketosis as well as Wernicke encephalopathy. Degradation of muscular proteins, muscular atrophy and altered liver function may also occur in more severe cases.
Arterial hypertension is relatively frequent gestational complication observed in 5–10% of pregnant women. Depend on clinical findings isolated hypertension, preeclampsia or eclampsia may be established in patients with pregnancy induced hypertension (PIH).
Preeclampsia seems to be one of more severe disorders observed in pregnancy. Hypertension, proteinuria and generalized edema are the main signs of these condition which may lead to eclampsia and HELLP syndrome. Premature placental ablation, internal hemorrhages into the brain tissue, liver and kidneys as well as premature labor are known as other complications associated with preeclampsia.
Intravascular hemolysis, altered liver function and low platelets count compose the syndrome known as HELLP which occurs mostly in patients with preeclampsia or eclampsia. Mothers’ mortality rate achieve the high level of %, whereas perinatal mortality of fetuses and neonates is determined as 10–40%.