Liver disease during pregnancy is more common than expected and may require specialized intervention. It is important to determine if changes in liver physiology may develop into liver disease, to assure early diagnosis. For adequate surveillance of mother-fetus health outcome, liver disease during pregnancy might require intervention from a hepatologist. Liver diseases have a prevalence of at least 3% of all pregnancies in developed countries, and they are classified into two main categories: related to pregnancy; and those non- related that are present de novo or are preexisting chronic liver diseases.

Pregnancy-specific disorders are the leading cause of abnormal LFTs during pregnancy, particularly in the third trimester. Pre-eclampsia-related disorder is the most common among these.

Clinical care in pregnant women with hepatic diseases can be challenging. There are physiologic changes in pregnancy that modify liver function diagnosis and clinical follow up. For this reason, liver disease during pregnancy requires early detection for adequate monitoring. Additionally, caring for pregnant women with pre-existing liver disease, such as hepatitis B and C, is difficult to manage and treatment must acknowledge fetal and maternal concerns. Interventions from the hepatologist, gastroenterologist and/or infectologist may be required. Pregnant women may be more susceptible to develop liver disease or increased severity of certain pre-existing liver diseases (e.g., gallbladder disease/cholelithiasis). These liver diseases and those that are pregnancy-related, such as HELLP syndrome, ICP, and AFLP, may represent a significant burden to the health care system because of the increased risk of complications developing in mothers and infants. The need to further explore liver disease in our pregnant population should be considered. 

Source: Medscape Womens Health, 1998 Mar;3(2):3