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Liver and Gallbladder Disorders During Pregnancy

By

Lara A. Friel

, MD, PhD, University of Texas Health Medical School at Houston, McGovern Medical School

Last full review/revision Oct 2021
CLICK HERE FOR THE PROFESSONAL VERSION
Topic Resources

Liver or gallbladder problems may result from hormonal changes during pregnancy. Some changes cause only minor, transient symptoms.

Cholestasis of pregnancy

Cholestasis of pregnancy can increase the risk of the following:

The most obvious symptom of cholestasis of pregnancy is intense itching all over the body (usually in the 2nd or 3rd trimester). No rash develops. Urine may be dark, and jaundice Jaundice in Adults In jaundice, the skin and whites of the eyes look yellow. Jaundice occurs when there is too much bilirubin (a yellow pigment) in the blood—a condition called hyperbilirubinemia. (See also Overview... read more Jaundice in Adults may develop.

For intense itching, a drug called ursodeoxycholic acid, taken by mouth, may be prescribed.

Cholestasis of pregnancy usually resolves after delivery but tends to recur in subsequent pregnancies or with use of oral contraceptives.

Cirrhosis

Fatty liver of pregnancy

This rare disorder can develop toward the end of pregnancy. The cause is unknown.

Symptoms of fatty liver of pregnancy include nausea, vomiting, abdominal discomfort, and jaundice. The disorder may rapidly worsen, and liver failure may develop. Preeclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more (a type of high blood pressure that develops during pregnancy) sometimes results.

Diagnosis of fatty liver of pregnancy is based on results of the doctor's evaluation, liver tests, and other blood 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. Consequently in such cases, doctors may recommend that the baby be delivered promptly or the pregnancy be terminated. Women who survive recover completely. Usually, fatty liver of pregnancy does not recur in subsequent pregnancies.

Gallstones

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.

Hepatitis

Acute viral hepatitis Overview of Acute Viral Hepatitis Acute viral hepatitis is inflammation of the liver caused by infection with one of the five hepatitis viruses. In most people, the inflammation begins suddenly and lasts only a few weeks. Symptoms... read more may increase the risk of premature birth. It is also the most common cause of jaundice during pregnancy. Pregnancy does not worsen most types of hepatis (hepatitis A, B, C, and D), but hepatitis E may become more severe during pregnancy.

Hepatitis B may be transmitted to the baby immediately after delivery or, less often, during the pregnancy. Most infected babies have no symptoms and have only mild liver dysfunction. But they may become carriers of the infection and transmit it to others. All pregnant women are tested for hepatitis, and if they are infected, measures are taken to prevent the baby from being infected.

Women with chronic hepatitis Overview of Chronic Hepatitis Chronic hepatitis is inflammation of the liver that lasts at least 6 months. Common causes include hepatitis B and C viruses and certain drugs. Most people have no symptoms, but some have vague... read more , especially if cirrhosis is present, may have difficulty becoming pregnant. If they become pregnant, they are more likely to miscarry or to give birth prematurely. If these women were taking corticosteroids before the pregnancy, they can continue to take these drugs during pregnancy. Sometimes, when the infection is severe, women with chronic hepatitis are given antiviral drugs during the 3rd trimester. These drugs may reduce the risk of transmitting the hepatitis virus to the fetus.

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