Women who have chronic viral hepatitis or scarring of the liver (cirrhosis) are more likely to miscarry or to give birth prematurely. Cirrhosis can cause varicose veins to develop around the esophagus (esophageal varices). Pregnancy slightly increases the risk of massive bleeding from these veins, especially during the last 3 months of pregnancy.
Liver or gallbladder problems may result from hormonal changes during pregnancy. Some changes cause only minor, transient symptoms.
Cholestasis of pregnancy:
The normal hormonal effects of pregnancy can slow the movement of bile through the bile ducts. This slowing is called cholestasis. The most obvious symptom is itching all over the body (usually in the last few months of pregnancy). No rash develops. If itching is intense, cholestyramine may be given.
The disorder usually resolves after delivery but tends to recur in subsequent pregnancies.
Fatty liver of pregnancy:
This rare disorder can develop toward the end of pregnancy. The cause is unknown. Symptoms include nausea, vomiting, abdominal discomfort, and jaundice. The disorder may rapidly worsen, and liver failure may develop.
Diagnosis is based on results of liver function tests and may be confirmed by a liver biopsy. The doctor may advise women to immediately end the pregnancy. The risk of death for pregnant women and the fetus is high in severe cases, but those who survive recover completely. Usually, the disorder does not recur in subsequent pregnancies.
Pregnant women who develop gallstones are closely monitored. If a gallstone blocks the gallbladder or causes an infection, surgery may be necessary. This surgery is usually safe for pregnant women and the fetus.
Last full review/revision December 2008 by Sean C. Blackwell, MD