妊娠期肝脏疾病新出现的病理事件

R. Behera, Amit Kumar, S. Chauhan, A. Grewal, Thakur Gurjeet Singh
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摘要

妊娠期妇女的肝功能障碍可由妊娠相关因素、妊娠期同时发生的疾病或先前存在的因妊娠而加重的肝脏疾病引起。由于各种可能的原因,3%至5%的妊娠出现肝脏检查结果异常,其临床影响从自限性到迅速致命不等。孕妇的肝脏检查异常主要由以下四种情况引起:(i)怀孕期间的生理变化,(ii)新获得的肝脏疾病,(iii)先前存在的肝脏疾病,以及(iv)与妊娠有关的肝脏疾病。孕妇的生理变化导致肝功能检查异常。肝脏疾病可导致母亲和胎儿的严重疾病和死亡。迅速查明该病至关重要,因为在危急情况下,立即分娩对母亲和发育中的婴儿的生存至关重要。这篇综述的重点是怀孕特有的肝脏问题。妊娠剧吐(HG),出现在怀孕的前12周,与肝损伤有关。妊娠期肝内胆汁淤积症(ICP)在妊娠中晚期最为突出。出生后瘙痒及胆汁淤积相关生化指标消退。先兆子痫和HELLP(肝酶升高、溶血和低血小板)都是妊娠后期出现的严重疾病。妊娠期急性脂肪肝(AFLP)是一种潜在的危险,罕见的疾病,可影响妊娠晚期。本文综述了妊娠期肝脏疾病的病因、发病机制、鉴别和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Emerging Pathological Events in Liver Diseases of Pregnancy
Hepatic dysfunction in a gestational woman can arises from pregnancy-related factors, illnesses that occur concurrently with gestation, or previously existing hepatic disorders which is aggravated by pregnancy. Abnormal liver test findings occur in 3% to 5% of pregnancies due to a variety of probable causes, with clinical effects ranging from self-limiting to swiftly deadly. Abnormal liver tests in pregnant individuals are caused by four major conditions: (i) Physiological changes in pregnancy, (ii) Newly acquired Liver disease, (iii) Pre-existing Liver disease, and (iv) Pregnancy- related Liver disease. Physiologic changes in pregnant women lead to abnormal liver function tests. Hepatic disorders may result in severe illness and death in both mothers as well as fetuses. Quick identification of the disease is crucial, as in critical situations immediate delivery is vital for the mother and developing infant survival. This review focuses on liver problems that are specific to pregnancy. Hyperemesis gravidarum (HG), which appears within the first 12 weeks of pregnancy, is connected to liver damage. Intrahepatic Cholestasis of Pregnancy (ICP) is the most prominent all across the middle and the end term of pregnancy. After birth, pruritus and the related biochemical indications of cholestasis resolve. Both pre-eclampsia and HELLP (elevated liver enzymes, hemolysis, and low platelets) are severe conditions that arise in the last term of pregnancy. Acute fatty liver during pregnancy (AFLP) is a potentially dangerous, uncommon condition that can affect pregnancy’s third trimester. This review summarizes the etiologies, pathogenesis, identification, and treatment of hepatic disorders during pregnancy.
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