Liver disease in pregnancy

Liver disease in pregnancy

Liver Diseases in Pregnancy: A Patient Education Guide

Liver diseases during pregnancy can include conditions unique to pregnancy or pre-existing or other unrelated liver disorders. Proper diagnosis and management are essential for the health of both the mother and the baby.

Types of Liver Diseases in Pregnancy:

  1. Pregnancy-Specific Liver Diseases:
    • Intrahepatic Cholestasis of Pregnancy (ICP): A condition causing severe itching and increased bile acids.
    • HELLP Syndrome: A severe complication involving Hemolysis, Elevated Liver Enzymes, and Low Platelets.
    • Acute Fatty Liver of Pregnancy (AFLP): A rare but serious condition causing liver dysfunction.
  2. Pre-existing Liver Diseases:
    • Chronic hepatitis (e.g., Hepatitis B or C)
    • Cirrhosis or liver fibrosis.
  3. Other Liver Conditions:
    • Gallstones or biliary diseases.

Why is it Important?

  • Liver diseases can lead to complications such as preterm labor, growth restriction in the baby, or maternal liver failure or death, if not properly managed.
  • Early diagnosis and treatment can significantly reduce risks.

Symptoms to Watch For:

  • Severe itching, especially on the hands and feet.
  • Jaundice (yellowing of the skin or eyes).
  • Persistent nausea or vomiting.
  • Upper right abdominal pain.
  • Fatigue and weakness.
  • Unusual bruising or bleeding.

Do's and Don'ts for Managing Liver Diseases in Pregnancy

Do's:

  • Attend Regular Check-ups: Regular monitoring of liver function tests and bile acid levels.
  • Report Symptoms Immediately: Notify your doctor about itching, yellow discoloration of eyes, or abdominal pain.
  • Follow a Healthy Diet: Include nutrient-dense foods and avoid fatty, processed meals.
  • Take Medications as Prescribed: Use only medications approved by your healthcare provider.
  • Consider Fetal Monitoring: Regular ultrasounds and non-stress tests to monitor baby’s health.

Don'ts:

  • Avoid Alcohol: Alcohol can worsen liver damage.
  • Do Not Self-Medicate: Over-the-counter drugs and supplements may harm the liver.
  • Limit Fatty Foods: High-fat diets can exacerbate liver conditions.
  • Avoid Skipping Appointments: Timely monitoring is crucial to prevent complications.
  • Do Not Delay Emergency Care: Seek help if symptoms worsen.

Medications for Liver Diseases in Pregnancy

For Intrahepatic Cholestasis of Pregnancy (ICP):

  • Ursodeoxycholic Acid (UDCA): The main treatment to lower bile acids and relieve itching.

For Hepatitis B:

  • Tenofovir: Safe and effective in preventing transmission to the baby.

For Hepatitis C:

  • Antiviral treatments (e.g., Sofosbuvir) are generally deferred until after pregnancy unless absolutely necessary.

For Symptom Management:

  • Antihistamines (e.g., Chlorpheniramine): May help with itching.

Safe Medications for Breastfeeding Mothers:

  • Ursodeoxycholic Acid (UDCA): Safe while breastfeeding.
  • Tenofovir: Compatible with breastfeeding for mothers with Hepatitis B.
  • Chlorpheniramine: Safe for symptom relief.

When to Seek Emergency Help:

  • Severe abdominal pain.
  • Confusion or extreme fatigue (possible liver failure).
  • Sudden onset of jaundice.
  • Uncontrolled bleeding or bruising.
  • Reduced fetal movements.

Conclusion:

Liver diseases in pregnancy require close monitoring and collaboration with your healthcare team. Timely diagnosis, appropriate treatments, and lifestyle modifications can help ensure a safe pregnancy and delivery. Always report symptoms promptly and follow medical advice closely.