Pregnancy-related liver disease AB

Question 1

Hyperemesis gravidarum - what LFT abnormalities are commonly seen?

Answer 1

Elevated aminotransferases in up to 50%

Rarely associated with liver failure

Question 2

In which trimesters does intrahepatic cholestasis of pregnancy occur?

Answer 2

2nd and 3rd trimester

Question 3

What are the symptoms of intraheptic cholestasis of pregnancy?

Answer 3

Pruritis

Jaundice in 10-25%

Question 4

What is the best diagnostic test for intraheptic cholestasis of pregnancy?

Answer 4

Elevated bile salts

Question 5

What are the foetal complications of intraheptic cholestasis of pregnancy?

Answer 5

Preterm labour
Fetal distress
Intrauterine death

Question 6

In which trimester does HELLP most commonly occur?

Answer 6

3rd trimester

Question 7

What is the maternal and foetal mortality rate associated with HELLP?

Answer 7

Maternal - up to 20%

Foetal - up to 33%

Question 8

When does HELLP typically resolve?

Answer 8

4-6 days post delivery

Question 9

How can you distinguish acute fatty liver of pregnancy from HELLP?

Answer 9

Indicators of hepatic failure (hypoglycaemia, coagulopathy) tend to be worse in AFLP

Question 10

What is the enzyme deficiency associated with acute fatty liver of pregnancy?

Answer 10

Long chain 3-hydroxyacyl-CoA dehydrogenase deficiency

Screen affected women and their children for this