Liver disorders in women during pregnancy: Expert shares some dos and don’ts to follow

Pregnancy, while an enjoyable phase, is also one that is crucial in terms of good health for the mother-to-be and her ba. Though rare, liver disease during pregnancy creates a challenge for gynecologs and hepatologs. Pregnancy-induced liver problems occur in about 3 per cent of cases.
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According to Dr Ankur Garg, director, surgical gastroenterology and liver transplant at Metro Group of Hospitals & Heart Institutes, there are three types of liver diseases that need to be differentiated during pregnancy:
1. Type one is directly related to pregnancy, which can occur at a specific time during pregnancy.2. Type two is not related to pregnancy, which can occur at any time, such as viral- or drug-induced hepatitis.3. Type three can occur in women with pre-exing liver disease.

“It is essential that clinicians are familiar with this disorder so they can respond promptly and appropriately in all of these situations, especially when emergency delivery is needed,” the doctor says.
Dr Garg adds that disorders unique to pregnancy-induced liver diseases are:
* Hyperemesis gravidarum (HG), which is too much nausea and vomiting leading to loss of appetite.* Intrahepatic cholestasis of pregnancy (ICP), jaundice.* Liver disorders associated with preeclampsia, specifically hemolysis, elevated liver enzymes, low platelet count syndrome (HELLP).* Hepatic infarction and hepatic rupture.* Acute fatty liver of pregnancy (AFLP).
He cautions that some of these conditions can be fatal for both the mother and her child, leading to maternal, fetal/neonatal morbidity and mortality.

It is crucial to watch out for signs for damage to the liver during pregnancy. (Photo: Getty/Thinkstock)
Early signs to look out for
– Too much vomiting and nausea leading to loss of appetite– Constant irritability and itching of skin– Pale skin and yellowing of urine or any level of jaundice development
According to the doctor, if there is progress in the aforementioned signs, it can lead to “bleeding, altered sensorium or disorientation towards time, place and person, ultimately leading to liver failure, warranting emergency liver transplant”.

Here are some dos and don’ts to follow
* Regular and timely follow up with the obstetrician.* Any deviation of liver functions to get diagnosed, with timely interventions.* Although some nausea, vomiting, itching is a part and parcel of normal pregnancy, in case of severity of symptoms, it should not be ignored.* Immediate consultation with a special is warranted.
“A few early signs can be managed with medicines and simple measures such as a low fat diet, wearing cotton clothes, frequent bathing with tepid water, avoiding too much heat exposure and sweating,” the doctor concludes.
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