11. The Liver in Pregnancy

  1. Eugene R. Schiff MD, MACP, FRCP2,
  2. Willis C. Maddrey MD, MACP, FRCP3 and
  3. Michael F. Sorrell MD, FACP4
  1. Yannick Bacq MD

Published Online: 31 OCT 2011

DOI: 10.1002/9781119950509.ch11

Schiff's Diseases of the Liver, Eleventh Edition

Schiff's Diseases of the Liver, Eleventh Edition

How to Cite

Bacq, Y. (2011) The Liver in Pregnancy, in Schiff's Diseases of the Liver, Eleventh Edition (eds E. R. Schiff, W. C. Maddrey and M. F. Sorrell), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119950509.ch11

Editor Information

  1. 2

    Center for Liver Diseases and Schiff Liver Institute, University of Miami Miller School of Medicine, Miami, FL, USA

  2. 3

    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

  3. 4

    University of Nebraska College of Medicine, Omaha, NE, USA

Author Information

  1. Department of Hepatogastroenterology, Centre Hospitalier de Tours, Hôpital Trousseau, Tours, France

Publication History

  1. Published Online: 31 OCT 2011
  2. Published Print: 9 DEC 2011

ISBN Information

Print ISBN: 9780470654682

Online ISBN: 9781119950509

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Keywords:

  • Pregnancy;
  • liver diseases;
  • viral hepatitis;
  • cholestasis;
  • biliary lithiasis;
  • fatty liver;
  • genetics

Summary

This chapter reviews the management of liver diseases in pregnant patients. In such patients it is essential that a liver disease is correctly diagnosed, because certain liver disorders can result in morbidity and/or mortality for the mother and the fetus. Early delivery has radically transformed the maternal and fetal prognosis of acute fatty liver of pregnancy. Pruritus occurring during the second or third trimester is the main symptom of intrahepatic cholestasis of pregnancy, which carries a risk for the fetus. Ursodeoxycholic acid is the most effective medical treatment. Intercurrent liver diseases, such as acute viral hepatitis, bacterial infections, or gallstone disease, should be considered in the differential diagnosis of abnormal liver tests occurring during any of the trimesters. Most patients suffering from chronic hepatitis B or C without cirrhosis have no increased risk during pregnancy. Neonates born to hepatitis B surface antigen-positive mothers should receive hepatitis B immunoglobulin and hepatitis B vaccine at birth to prevent perinatal transmission of hepatitis B virus.