Liver and Gallbladder Disorders During Pregnancy

The normal hormonal effects of pregnancy can slow the movement of bile through the bile ducts. This slowing is called cholestasis Cholestasis Cholestasis is reduction or stoppage of bile flow. Bile is the digestive fluid produced by the liver. Disorders of the liver, bile duct, or pancreas can cause cholestasis. The skin and whites... read more .

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 may develop.

For intense itching, a medication 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 Cirrhosis of the Liver Cirrhosis is the widespread distortion of the liver's internal structure that occurs when a large amount of normal liver tissue is permanently replaced with nonfunctioning scar tissue. The scar... read more (scarring of the liver) increases the risk of miscarrying Miscarriage A miscarriage is the loss of a fetus before 20 weeks of pregnancy. Miscarriages may occur because of a problem in the fetus (such as a genetic disorder or birth defect) or in the woman (such... read more or giving birth prematurely Preterm Labor Labor that occurs before 37 weeks of pregnancy is considered preterm. Babies born prematurely can have serious health problems. The diagnosis of preterm labor is usually obvious. Measures such... read more .

Cirrhosis can cause varicose veins (widened, convoluted veins) to develop around the esophagus (called esophageal varices Esophageal Varices Esophageal varices are enlarged veins in the esophagus, which can cause major bleeding. Esophageal varices are caused by high blood pressure in blood vessels in and around the liver (portal... read more ). Pregnancy slightly increases the risk that these veins will bleed profusely, especially during the last 3 months 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 Liver Failure Liver failure is severe deterioration in liver function. Liver failure is caused by a disorder or substance that damages the liver. Most people have jaundice (yellow skin and eyes), feel tired... read more 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 Gallstones Gallstones are collections of solid material (predominantly crystals of cholesterol) in the gallbladder. The liver can secrete too much cholesterol, which is carried with bile to the gallbladder... read more appear to be more common during pregnancy. 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.

Acute viral hepatitis Overview of Acute Viral Hepatitis Acute viral hepatitis is inflammation of the liver, generally meaning inflammation caused by infection with one of the five hepatitis viruses. In most people, the inflammation begins suddenly... 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 medications during pregnancy. Sometimes, when the infection is severe, women with chronic hepatitis are given antiviral medications during the 3rd trimester. These medications may reduce the risk of transmitting the hepatitis virus to the fetus.