Hepatic Complications in Pregnancy

Question 1

What complication occurs with viral hepatitis in pregnancy?

Answer 1

HAV-HDV:

-no/minimal complications unique to pregnancy

HEV:

-20% lethality in pregnancy that is not seen elsewhere

Question 2

What is preeclampsia?

(timing, characteristics

Answer 2

Typically onset >20 wks gestation

characterized by:

• gestational HTN
• protenuria
• renal insufficiency
• peripheral edema
• coagulation abnormalities

Question 3

What laboratory findings are seen in preeclampsia?

Answer 3

• thrombocytopenia
• elevated creatinine (doubling if chronically elevated)
• elevated AST/ALT
• proteinuria

Question 4

What is HELLP syndrome?

Answer 4

severe form of preeclampsia

Characterized by:

• H: hemolysis
• EL: elevated liver enzymes
• LP: low platelets

Question 5

What is eclampsia?

Answer 5

life threatening progression of preeclampsia to include:

• hyperreflexia
• convulsions

Question 6

What is acute fatty liver of pregnancy?

Answer 6

There is a typical increase in adiposity of the liver in pregnancy that is benign

occasionally a severe form that results in rapid replacement of a majority of the liver with fat occurs resulting in liver failure and death

-typically third trimester

Question 7

What is the response to actue fatty liver of pregnancy

Question 8

How is acute fatty liver of pregnancy treated?

Answer 8

-requires termination of pregnancy to prevent continued replacement of liver with fat

Question 9

What is intrahepatic cholestasis of pregnancy?

Answer 9

cholestasis presumed to be caused by pregnancy hormones resulting in:

• pruritis
• conjugated hyperbilirubinemia
• occasionally darkened urine
• occasionally light/acolic stools

Question 10

What is the most common cause of jaundice in pregnancy?

Answer 10

-viral hepatitis