Bernuau Jacques
Service d'hépatologie, Hôpital Beaujon, 92118 Clichy.
Rev Prat. 2003 Nov 15;53(17):1889-93.
Liver diseases specific of pregnancy, the most common hepatic complications of pregnancy, are always associated with a sometimes asymptomatic increase in serum aminotransferase activity. The most frequent of the liver diseases specific of pregnancy in normotensive pregnant women is cholestasis of pregnancy, the cause of generalised pruritus, and, in those with pregnancy-induced hypertension, preeclampsia which requires short-term cessation of pregnancy. Similar treatment is required by acute fatty liver of pregnancy the diagnosis of which must be done in the third trimester when recent polydipsia, nausea or vomiting occurs. Moreover, pregnancy increases the incidence and/or the severity of herpes simplex hepatitis (for which acyclovir therapy is urgently required) and hepatitis type E. Pregnancy may also unmask untreated cases of autoimmune hepatitis, Wilson's disease or Budd-Chiari syndrome.
妊娠特异性肝病是妊娠最常见的肝脏并发症,常伴有血清转氨酶活性有时无症状升高。血压正常的孕妇中最常见的妊娠特异性肝病是妊娠胆汁淤积症,可导致全身瘙痒;而在妊娠高血压患者中,则是子痫前期,需要短期终止妊娠。妊娠急性脂肪肝也需要类似的治疗,其诊断必须在妊娠晚期出现近期烦渴、恶心或呕吐时进行。此外,妊娠会增加单纯疱疹病毒性肝炎(急需阿昔洛韦治疗)和戊型肝炎的发病率和/或严重程度。妊娠还可能使自身免疫性肝炎、威尔逊病或布加综合征的未治疗病例显现出来。