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Tuesday, February 5, 2008

Pregnancy and Liver Function

How does pregnancy affect the liver?
Pregnancy has little effect on a normal liver. There are no significant changes in liver function during pregnancy, but some markers of liver function may alter slightly. For example, alkaline phosphatase may go up modestly as the pregnancy advances, due to its production by a normal placenta. Blood levels of albumin will decrease because of the dilution of an expectant mother’s blood. However, any abnormalities in standard tests (bilirubin, aminotransferase, or protime) should be considered an indication of possible liver problems.

Why do some pregnant women experience jaundice?
The onset of jaundice during pregnancy is usually related to impaired bile flow. In susceptible individuals, the liver’s ability to handle bile acids may change during pregnancy, due to the effects of estrogen, which increases during pregnancy. In general, there are no lasting consequences for the mother, but there is an increased risk of premature birth or stillbirth for the baby in affected pregnancies. All pregnant women with jaundice must undergo evaluation by a physician to determine the cause of their jaundice.

What effect does toxemia have on the liver?
Toxemia is a common disorder of late pregnancy. It includes high blood pressure, leg swelling or edema, and kidney dysfunction. In approximately 10% of women with toxemia, the liver is also affected. Blood clots form, and there is bleeding into the liver. In severe cases, this can be life threatening. In mild cases, liver function remains normal even though liver blood tests may be abnormal.

What is HELLP syndrome?
The HELLP Syndrome is part of the liver disease that affects women with toxemia. Its name is derived from abbreviations for hemolysis (the breakdown of red blood cells), elevated liver tests, and low platelets in the blood. The disease stops with delivery, and the liver generally heals itself within weeks. During the active stages of the disease, the mother is a risk of liver damage and bleeding, and the baby risks premature delivery or stillbirth.

What is the affect of alcohol on a pregnant woman's liver?
Moderate alcohol consumption (one or two drinks daily) probably does not affect the liver of an otherwise normal pregnant woman, but even moderate doses may cause damage to the fetus.

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