Liver disorders during pregnancy and their management

INTRODUCTION During pregnancy, the human body undergoes several changes in the process of its adaptation to the growing fetus. Although these changes are physiological, there is potential for morbidity and mortality to both mother and fetus. Liver is the site of many important metabolic and synthetic functions of the body. In normal pregnancy, the liver is not palpable. Due to hemodilution, biochemical tests may reveal mild increase in liver function tests. Abnormal liver tests occur in 3%-5% of pregnancies, with many potential causes, including coincidental liver disease (most commonly viral hepatitis or gallstones) and underlying chronic liver disease (Table 1). Wide multitudes of liver diseases are encountered in pregnancy. For instance, the liver could be the target of diseases specific to the pregnancy such as intrahepatic cholestasis of pregnancy and acute fatty liver of pregnancy, and there are no available means by which to predict with certainty how and when such illnesses may occur. In tropical countries like India, morbidity and mortality due to liver diseases in pregnancy is very high.