AISF position paper on liver disease and pregnancy

Dig Liver Dis. 2016 Feb;48(2):120-37. doi: 10.1016/j.dld.2015.11.004. Epub 2015 Nov 14.

Abstract

The relationship between liver disease and pregnancy is of great clinical impact. Severe liver disease in pregnancy is rare; however, pregnancy-related liver disease is the most frequent cause of liver dysfunction during pregnancy and represents a severe threat to foetal and maternal survival. A rapid differential diagnosis between liver disease related or unrelated to pregnancy is required in women who present with liver dysfunction during pregnancy. This report summarizes the recommendation of an expert panel established by the Italian Association for the Study of the Liver (AISF) on the management of liver disease during pregnancy. The article provides an overview of liver disease occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and an assessment of the available treatment options. The report contains in three sections: (1) specific liver diseases of pregnancy; (2) liver disease occurring during pregnancy; and (3) pregnancy in patients with pre-existing chronic liver disease. Each topic is discussed considering the most relevant data available in literature; the final statements are formulated according to both scientific evidence and clinical expertise of the involved physicians, and the AISF expert panel recommendations are reported.

Keywords: Liver diseases; Pregnancy.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Budd-Chiari Syndrome / therapy
  • Calcium Channel Blockers / therapeutic use
  • Cholagogues and Choleretics / therapeutic use
  • Cholelithiasis / therapy
  • Cholestasis, Intrahepatic / therapy
  • Eclampsia / therapy
  • Fatty Liver / therapy
  • Female
  • Fluid Therapy
  • HELLP Syndrome / therapy
  • Hepatitis, Viral, Human / prevention & control
  • Hepatitis, Viral, Human / therapy
  • Humans
  • Hyperemesis Gravidarum / therapy
  • Italy
  • Liver Diseases / therapy*
  • Magnesium Sulfate / therapeutic use
  • Pre-Eclampsia / therapy
  • Pregnancy
  • Pregnancy Complications / therapy*
  • Pregnancy Complications, Infectious / prevention & control
  • Pregnancy Complications, Infectious / therapy
  • Societies, Medical
  • Thiamine / therapeutic use
  • Ursodeoxycholic Acid / therapeutic use
  • Viral Hepatitis Vaccines / therapeutic use
  • Vitamin B Complex / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Cholagogues and Choleretics
  • Viral Hepatitis Vaccines
  • Vitamin B Complex
  • Ursodeoxycholic Acid
  • Magnesium Sulfate
  • Thiamine

Supplementary concepts

  • Acute fatty liver of pregnancy
  • Intrahepatic Cholestasis of Pregnancy