Liver abnormalities in pregnancy

Best Pract Res Clin Gastroenterol. 2013 Aug;27(4):565-75. doi: 10.1016/j.bpg.2013.06.015.


Abnormalities of liver function (notably rise in alkaline phosphatase and fall in serum albumin) are common in normal pregnancy, whereas rise in serum bilirubin and aminotransferase suggest either exacerbation of underlying pre-existing liver disease, liver disease related to pregnancy or liver disease unrelated to pregnancy. Pregnant women appear to have a worse outcome when infected with Hepatitis E virus. Liver diseases associated with pregnancy include abnormalities associated hyperemesis gravidarum, acute fatty liver disease, pre-eclampsia, cholestasis of pregnancy and HELLP syndrome. Prompt investigation and diagnosis is important in ensuring a successful maternal and foetal outcome. In general, prompt delivery is the treatment of choice for acute fatty liver, pre-eclampsia and HELLP syndrome and ursodeoxycholic acid is used for cholestasis of pregnancy although it is not licenced for this indication.

Keywords: Acute fatty liver; Cholestasis of pregnancy; HELLP syndrome; Liver disease; Pre-eclampsia; Pregnancy.

Publication types

  • Review

MeSH terms

  • Fatty Liver / physiopathology*
  • Female
  • HELLP Syndrome / physiopathology*
  • Humans
  • Liver Diseases / diagnosis
  • Liver Diseases / physiopathology*
  • Liver Diseases / therapy
  • Pre-Eclampsia / physiopathology*
  • Pregnancy
  • Pregnancy Complications / physiopathology*

Supplementary concepts

  • Acute fatty liver of pregnancy