Liver disease during pregnancy is least studied in the field of obstetrics, which creates a challenge for both gynecologists and hepatologists. About 3% of pregnant women are known to be affected by some form of liver disease during pregnancy. Some of which can be fatal for both the mother and child. 

3 types of liver disease should be differentiated during pregnancy-

• Liver-disease directly related to pregnancy, which occurs at a specific time during pregnancy, like Hyperemesis gravidarum, Intrahepatic cholestasis of pregnancy, Acute fatty liver of pregnancy, Preeclampsia, eclampsia, and HELLP syndrome.
• Liver disease not related to pregnancy, which occurs at any time, like viral- or drug-induced hepatitis. 
• Pregnant women with pre-existing liver disease like Cirrhosis and portal hypertension etc.

Pregnancy-related liver disease is the commonest cause of liver dysfunction during pregnancy. It must be remembered that pregnancy is associated with many normal physiological changes that must be assessed during diagnosing liver disease. Pregnancy-related liver disorders show trimester-specific characteristics in their occurrence, while non-pregnancy-related liver diseases may be reported at any time. The timing of clinical manifestations and liver test result abnormalities play a crucial role in determining the diagnosis and treatment strategies. 

Clinicians should be familiar with this disorder, to facilitate prompt response and handle any emergency.

Source- Mikolasevic I, Filipec-Kanizaj T, Jakopcic I, et al. Liver Disease During Pregnancy: A Challenging Clinical Issue. Med Sci Monit. 2018;24:4080-4090. doi:10.12659/MSM.907723