Verma Dhruv, Saab Adelaide M, Saab Sammy, El-Kabany Mohamed
Department of Medicine, University of California at Los Angeles, Los Angeles, California.
Department of Surgery, University of California at Los Angeles, Los Angeles, California.
Gastroenterol Hepatol (N Y). 2021 Jul;17(7):322-329.
Consultation for liver disease during pregnancy is challenging for both the hepatologist and gynecologist, as normal physiologic changes during pregnancy can mimic chronic liver disease. Pregnancy-specific liver disorders are leading causes of abnormal liver function tests during pregnancy. Moreover, up to 3% of all pregnant women in developed countries experience liver diseases nonspecific to pregnancy. When severe, pregnancy-specific liver disorders are associated with significant morbidity and mortality for both the mother and the fetus. The main factors that determine maternal prognosis are the type of liver disease; degree of impaired synthetic, metabolic, and excretory liver function; and timing of delivery. This article focuses on a systematic approach to diagnosing and managing pregnancy-specific liver disorders, which includes understanding normal findings in pregnancy, excluding liver diseases nonspecific to pregnancy, factoring in trimester status, and using clinical clues to make a diagnosis and provide treatment in a timely fashion.
孕期肝病的会诊对肝病专家和妇科医生来说都具有挑战性，因为孕期正常的生理变化可能会与慢性肝病相似。孕期特有的肝脏疾病是孕期肝功能检查异常的主要原因。此外，在发达国家，高达3%的孕妇会患上非孕期特有的肝病。严重时，孕期特有的肝脏疾病会给母亲和胎儿带来显著的发病率和死亡率。决定母亲预后的主要因素包括肝病的类型、肝脏合成、代谢和排泄功能受损的程度以及分娩时间。本文重点介绍一种诊断和管理孕期特有的肝脏疾病的系统方法，包括了解孕期的正常表现、排除非孕期特有的肝病、考虑孕期阶段情况以及利用临床线索及时进行诊断和治疗。
