Pregnancy is a significant milestone for couples worldwide, but it comes with its own set of challenges. During this period, doctors emphasise the importance of focussing on health, immunity, and nutrition. This is because pregnant women are at an increased risk of various health issues, such as anaemia, high blood pressure, and gestational diabetes.
Liver health is another crucial aspect that requires attention during pregnancy. Although liver disease during pregnancy is relatively rare, it's always wise to take preventive measures. In a discussion with the OnlyMyHealth team, Dr Danny Laliwala, Consultant - Obstetrics and Gynaecology, Jaslok Hospital and Research Centre, Mumbai, sheds light on the potential liver problems that can arise during pregnancy.
Liver Disorders During Pregnancy
Liver disorders during pregnancy can affect both the mother and the foetus, says Dr Laliwala. He adds that some liver problems may be mild and self-limiting, while others may be fatal to both the mother and the foetus, with maternal and foetal morbidity and mortality reaching up to 50% in a few.
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According to an article published in StatPearls Publishing, managing liver disease during pregnancy can be challenging due to various factors. The physiological and anatomical changes that occur during pregnancy, along with the complex interactions between the mother and foetus, add to the difficulty. Additionally, the rarity of liver disease in pregnancy presents unique challenges for hepatologists in providing effective care, the research notes.
Some of the liver conditions that can occur during pregnancy include:
Hyperemesis gravidarum
This is excessive vomiting in pregnancy, which can lead to dehydration and elevation of liver enzymes. With proper hydration and correction of vomiting, usually the liver enzymes revert back.
Intra hepatic cholestasis of pregnancy
The condition presents with extreme itching all over the body. Both serum bile acids and liver enzymes increase. To manage the condition, doctors usually prescribe ursodeoxycholic acid tablets along with calamine lotion for local application.
HELLP syndrome
This condition is associated with high blood pressure and may affect the liver. Diagnosis involves blood tests revealing haemolysis, elevated liver enzymes, and low platelet count. Management focuses on controlling blood pressure and preparing for imminent delivery.
Acute fatty liver of pregnancy (AFLP)
AFLP is associated with jaundice and rapidly deteriorating liver failure in the last 2-3 months of pregnancy. Along with jaundice, patients may also experience excessive nausea and vomiting, abdominal pain, and generalised weakness. According to a research article published in UpToDate, AFLP is rare, with an approximate incidence of one in 7000–20,000 pregnancies.
Infectious hepatitis in pregnancy
Infectious hepatitis in pregnancy is caused by viruses, which may be transmitted by oral routes, mainly by water. Liver enzymes along with bilirubin increase, leading to jaundice, characterised by the yellowing of the skin.
Symptoms To Watch Out For Liver Health
Dr Laliwala advises reporting abnormal symptoms, such as itching, yellow-coloured eyes or urine, excessive nausea and vomiting after the fourth month of pregnancy, or upper abdominal pain.
He says, “The doctor may ask for certain specific tests to be done, like liver function tests and maternal ultrasound to look for any abnormalities in the liver.”
How To Reduce The Risk
According to the expert, liver disorders can be fatal during pregnancy. To reduce the risk, he advises having boiled water, washing hands with soap and water before meals, and completely avoiding outside food, especially during monsoons.
He further recommends eating small, frequent meals that are rich in proteins while avoiding oily and spicy food during pregnancy.