Archer J S
Department of Obstetrics and Gynecology, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, USA.
J Reprod Med. 2001 Feb;46(2):137-40.
Liver disease in pregnancy can be grossly divided into those disorders coincidentally occurring during the pregnant state and hepatic diseases limited to pregnancy. Numerous infectious agents can result in acute hepatitis and include not only the hepatitis viruses--A, B, C and E--but herpesvirus and cytomegalovirus as well. Coxsackie B viruses can cause several clinical presentations, ranging from asymptomatic to mild febrile illness to myocarditis and meningitis. Rarely has coxsackievirus infection been associated with fulminant hepatic failure.
A Coxsackie B virus infection resulted in acute liver failure in a gravid woman. The patient was managed expectantly, with resolution of the liver disease and delivery five weeks after discharge.
The onset of hepatic disease is insidious, with only vague symptoms or minor complaints often heralding the progression to liver failure. A careful history, physical examination and appropriate diagnostic tests can help determine the etiology of hepatic disease and help decide whether expectant management of the gravid patient or immediate delivery is appropriate.
妊娠期肝病大致可分为妊娠期间偶然发生的疾病和仅限于妊娠期的肝脏疾病。许多感染因子可导致急性肝炎，不仅包括甲型、乙型、丙型和戊型肝炎病毒，还包括疱疹病毒和巨细胞病毒。柯萨奇B病毒可引起多种临床表现，从无症状到轻度发热性疾病，再到心肌炎和脑膜炎。柯萨奇病毒感染很少与暴发性肝衰竭相关。
一名孕妇因柯萨奇B病毒感染导致急性肝衰竭。患者接受了期待治疗，肝病得以缓解，并在出院五周后分娩。
肝病起病隐匿，通常只有模糊的症状或轻微的不适预示着病情进展至肝衰竭。详细的病史、体格检查和适当的诊断测试有助于确定肝病的病因，并有助于决定对孕妇进行期待治疗还是立即分娩是否合适。
