Sasamori Yukifumi, Tanaka Atsushi, Ayabe Takuya
Department of Obstetrics and Gynecology.
Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Hepatol Res. 2020 Sep;50(9):1015-1023. doi: 10.1111/hepr.13540. Epub 2020 Jul 13.
Development of liver diseases during pregnancy is not uncommon. They are caused by either a disorder that is unique to pregnancy or an acute or chronic liver disease that already exists or coincidentally develops as a comorbidity of pregnancy. Liver diseases unique to pregnancy include hyperemesis gravidarum; hypertensive disorders of pregnancy, such as pre-eclampsia/eclampsia; hemolysis, elevated liver enzymes, and low platelet count syndrome; intrahepatic cholestasis of pregnancy; and acute fatty liver of pregnancy. Chronic liver diseases that affect pregnancy, or are affected by pregnancy, mainly include autoimmune liver diseases and non-alcoholic fatty liver disease. Prompt diagnosis and management of liver diseases in pregnancy, while very challenging, is extremely important, as they might cause adverse maternal and fetal outcomes. Therefore, a multidisciplinary, collaborative approach involving both hepatologists and obstetricians is required. In this review article, the up-to-date epidemiology, etiology, clinical features, and outcomes of liver diseases in pregnancy are discussed, to promote a deeper understanding among physicians, and subsequently improved outcomes.
孕期发生肝脏疾病并不罕见。它们要么由孕期特有的病症引起，要么由已存在的急性或慢性肝脏疾病引起，或者作为孕期合并症偶然发生。孕期特有的肝脏疾病包括妊娠剧吐；妊娠期高血压疾病，如先兆子痫/子痫；溶血、肝酶升高和血小板减少综合征；妊娠期肝内胆汁淤积症；以及妊娠急性脂肪肝。影响妊娠或受妊娠影响的慢性肝脏疾病主要包括自身免疫性肝病和非酒精性脂肪性肝病。孕期肝脏疾病的及时诊断和管理虽然极具挑战性，但极为重要，因为它们可能导致不良的母婴结局。因此，需要肝病学家和产科医生采取多学科协作方法。在这篇综述文章中，讨论了孕期肝脏疾病的最新流行病学、病因、临床特征和结局，以促进医生之间的深入理解，进而改善结局。
