The Royal Free Hospital, Sheila Sherlock Liver Centre, Pond Street, London NW3 2QG, UK.
The Royal Free Hospital, Sheila Sherlock Liver Centre, Pond Street, London NW3 2QG, UK.
J Hepatol. 2016 Apr;64(4):933-45. doi: 10.1016/j.jhep.2015.11.030. Epub 2015 Nov 30.
Pregnancy associated liver diseases affect up to 3% of pregnant women and are the most frequent cause of liver dysfunction in pregnancy. When severe, they are associated with significant morbidity and mortality for both mother and infant. A rapid evaluation to distinguish them from non-pregnancy related liver dysfunction is essential, in order to facilitate appropriate management. Liver disease unrelated to pregnancy can present de novo in pregnancy, or pregnancy can occur in women with preexisting liver pathology (Table 1). Research and subsequent advances in medical care have resulted in improved but still not satisfactory maternal and fetal outcomes. In this review we provide an overview of the liver diseases specific to the pregnant state and an update on their pathogenesis, treatment and outcomes. The risks of pregnancy in women with pre-existent liver pathology is detailed and recent advances in our understanding of specific risks and outcomes are discussed.
妊娠相关肝病影响高达 3%的孕妇,是妊娠期间肝功能障碍的最常见原因。严重时,会导致母婴发病率和死亡率显著增加。快速评估将其与非妊娠相关肝功能障碍区分开来至关重要,以便进行适当的管理。与妊娠无关的肝病可在妊娠期间新出现,也可发生于有既往肝病史的妇女(表 1)。研究和随后的医疗保健进展改善了但仍不理想的母婴结局。在这篇综述中,我们概述了妊娠特有的肝病,并更新了其发病机制、治疗和结局。详细介绍了妊娠存在肝病史的风险,并讨论了我们对特定风险和结局的最新认识。