Liver Disease in Pregnancy Flashcards Preview

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Flashcards in Liver Disease in Pregnancy Deck (9)
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1
Q

What are some liver disease findings in pregnancy?

A

Spider angiomas
Palmar erythema
Decreased gallbladder contractility (increased risk of gallstones)
Increase alk phase
Decreased hematocrit, serum urea, uric acid, albumin, total protein

2
Q

When does hyperemesis gravidarum occur?

A

First trimester

3
Q

What happens to liver enzymes with hyperemesis gravidarum?

A

ALT 2-3 fold elevation, can reach 20-fold

Treatment: symptomatic with rehydration and antiemetics

4
Q

Intrahepatic cholestatsis of pregnancy

A

Pruritus resolves within 2 days of pregnancy
Increased risk of prematurity, perinatal deaths, fetal stress
Typically occurs in 3rd trimester, but can be at anytime
Jaundice in 25%
Up to 4-fold AST/ALT increase
Serum bile acids increased 30-100 fold

5
Q

What do you use to treat Intrahepatic cholestasis of pregnancy?

A

Cholestyramine-binds bile acids

Ursodesoxycholic acid- modifies bile acid pool, inhibits absorption of more hydrophobic bile acids

6
Q

What is preeclampsia?

A

Hypertension, proteinuria, edema

Typically occurring after 20 weeks

7
Q

What is eclampsia?

A

Preeclampsia + seizures

AST and ALT elevations in 80-90%

8
Q

What causes acute fatty liver of pregnancy (AFLP)?

A

Fatty acid oxidation defect in fetus –> long-chain 3-hydroxyacyl coenzyme dehydrogenase deficiency in fetus with a heterozygote mother

Ranges from mild to severe
Presents in third trimester
Urgent delivery indicated

9
Q

HELLP Syndrome

A

Hemolytic anemia
Elevated Liver tests
Low Platelets

Occurs in 3rd trimester
Urgent delivery indicated
Complication of preeclampsia/eclampsia