Advertisement
Review Article| Volume 27, ISSUE 1, P133-155, February 2023

Evaluation of Liver Disease in Pregnancy

Published:October 17, 2022DOI:https://doi.org/10.1016/j.cld.2022.08.009

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Clinics in Liver Disease
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Tran T.T.
        • Ahn J.
        • Reau N.S.
        ACG clinical guideline: liver disease and pregnancy.
        Am J Gastroenterol. 2016; 111 ([quiz: 196]): 176-194
        • Sarkar M.
        • Brady C.W.
        • Fleckenstein J.
        • et al.
        Reproductive health and liver disease: Practice guidance by the American association for the study of liver diseases.
        Hepatology. 2021; 73: 318-365
        • Ch'ng C.L.
        • Morgan M.
        • Hainsworth I.
        • et al.
        Prospective study of liver dysfunction in pregnancy in Southwest Wales.
        Gut. 2002; 51: 876-880
        • García-Romero C.S.
        • Guzman C.
        • Cervantes A.
        • et al.
        Liver disease in pregnancy: medical aspects and their implications for mother and child.
        Ann Hepatol. 2019; 18: 553-562
        • Ellington S.R.
        • Flowers L.
        • Legardy-Williams J.K.
        • et al.
        Recent trends in hepatic diseases during pregnancy in the United States, 2002-2010.
        Am J Obstet Gynecol. 2015; 212: 524 e1-7
        • Goodwin T.M.
        Hyperemesis gravidarum.
        Obstet Gynecol Clin North Am. 2008; 35 (viii): 401-417
        • Jarvis S.
        • Nelson-Piercy C.
        Management of nausea and vomiting in pregnancy.
        Bmj. 2011; 342: d3606
        • Fejzo M.S.
        • Arzy D.
        • Tian R.
        • et al.
        Evidence GDF15 Plays a role in familial and recurrent hyperemesis gravidarum.
        Geburtshilfe Frauenheilkd. 2018; 78: 866-870
        • Fejzo M.S.
        • Ingles S.A.
        • Wilson M.
        • et al.
        High prevalence of severe nausea and vomiting of pregnancy and hyperemesis gravidarum among relatives of affected individuals.
        Eur J Obstet Gynecol Reprod Biol. 2008; 141: 13-17
        • Golberg D.
        • Szilagyi A.
        • Graves L.
        Hyperemesis gravidarum and Helicobacter pylori infection: a systematic review.
        Obstet Gynecol. 2007; 110: 695-703
        • Verberg M.F.G.
        • Gillott D.J.
        • Al-Fardan N.
        • et al.
        Hyperemesis gravidarum, a literature review.
        Hum Reprod Update. 2005; 11: 527-539
        • Westbrook R.H.
        • Dusheiko G.
        • Williamson C.
        Pregnancy and liver disease.
        J Hepatol. 2016; 64: 933-945
      1. Outlaw WM, Ibdah JA, Koch KL. Hyperemesis Gravidarum and Maternal Liver Disease. Madame Curie Bioscience Database [Internet]. Landes Bioscience; 2013.

        • Rolfes D.B.
        • Ishak K.G.
        Liver disease in pregnancy.
        Histopathology. 1986; 10: 555-570
        • Geenes V.
        • Williamson C.
        Intrahepatic cholestasis of pregnancy.
        World J Gastroenterol. 2009; 15: 2049-2066
        • Bicocca M.J.
        • Sperling J.D.
        • Chauhan S.P.
        Intrahepatic cholestasis of pregnancy: review of six national and regional guidelines.
        Eur J Obstet Gynecol Reprod Biol. 2018; 231: 180-187
        • Dixon P.H.
        • Sambrotta M.
        • Chambers J.
        • et al.
        An expanded role for heterozygous mutations of ABCB4, ABCB11, ATP8B1, ABCC2 and TJP2 in intrahepatic cholestasis of pregnancy.
        Sci Rep. 2017; 7: 11823
        • Ovadia C.
        • Williamson C.
        Intrahepatic cholestasis of pregnancy: recent advances.
        Clin Dermatol. 2016; 34: 327-334
        • Monrose E.
        • Bui A.
        • Rosenbluth E.
        • et al.
        Burden of future liver abnormalities in patients with intrahepatic cholestasis of pregnancy.
        Am J Gastroenterol. 2021; 116: 568-575
        • Kaneuchi Y.
        • Sekiguchi M.
        • Kameda T.
        • et al.
        Temporal and Spatial changes of mu-opioid Receptors in the Brain, Spinal Cord and Dorsal Root Ganglion in a Rat Lumbar Disc Herniation Model.
        Spine (Phila Pa 1976). 2019; 44: 85-95
        • Chappell L.C.
        • Bell J.L.
        • Smith A.
        • et al.
        Ursodeoxycholic acid versus placebo in women with intrahepatic cholestasis of pregnancy (PITCHES): a randomised controlled trial.
        Lancet. 2019; 394: 849-860
        • Walker K.F.
        • Chappell L.C.
        • Hague W.M.
        • et al.
        Pharmacological interventions for treating intrahepatic cholestasis of pregnancy.
        Cochrane Database Syst Rev. 2020; : 7https://doi.org/10.1002/14651858.CD000493.pub3
      2. Available at: https://www.clinicaltrialsregister.eu/ctr-search/trial/2018-004011-44/FI. Accessed March 13, 2021.

      3. Available at: https://clinicaltrials.gov/ct2/show/NCT04718961. Accessed March 13, 2021.

        • Bradley H.
        • Hall E.W.
        • Rosenthal E.M.
        • et al.
        Hepatitis C virus prevalence in 50 U.S. States and D.C. By Sex, birth cohort, and Race: 2013-2016.
        Hepatol Commun. 2020; 4: 355-370
        • Mol B.W.J.
        • Roberts C.T.
        • Thangaratinam S.
        • et al.
        Pre-eclampsia.
        Lancet. 2016; 387: 999-1011
        • Seely E.W.
        • Tsigas E.
        • Rich-Edwards J.W.
        Preeclampsia and future cardiovascular disease in women: How good are the data and how can we manage our patients?.
        Semin Perinatol. 2015; 39: 276-283
        • Roberge S.
        • Nicolaides K.
        • Demers S.
        • et al.
        The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis.
        Am J Obstet Gynecol. 2017; 216: 110-120.e6
        • Martin Jr., J.N.
        • Owens M.Y.
        • Keiser S.D.
        • et al.
        Standardized Mississippi Protocol treatment of 190 patients with HELLP syndrome: slowing disease progression and preventing new major maternal morbidity.
        Hypertens Pregnancy. 2012; 31: 79-90
        • Knight M.
        • Nelson-Piercy C.
        • Kurinczuk J.J.
        • et al.
        A prospective national study of acute fatty liver of pregnancy in the UK.
        Gut. 2008; 57: 951-956
        • Browning M.F.
        • Levy H.L.
        • Wilkins-Haug L.E.
        • et al.
        Fetal fatty acid oxidation defects and maternal liver disease in pregnancy.
        Obstet Gynecol. 2006; 107: 115-120
        • Ibdah J.A.
        • Bennett M.J.
        • Rinaldo P.
        • et al.
        A fetal fatty-acid oxidation disorder as a cause of liver disease in pregnant women.
        N Engl J Med. 1999; 340: 1723-1731
        • Hay J.E.
        Liver disease in pregnancy.
        Hepatology. 2008; 47: 1067-1076
        • Kushner T.
        • Tholey D.
        • Dodge J.
        • et al.
        Outcomes of liver transplantation for acute fatty liver disease of pregnancy.
        Am J Transplant. 2019; 19: 2101-2107
        • Rebahi H.
        • Still M.E.
        • El Adib A.R.
        A successful use of therapeutic plasma exchange in a fulminant form of acute fatty liver of pregnancy.
        J Gynecol Obstet Hum Reprod. 2019; 48: 133-137https://doi.org/10.1016/j.jogoh.2018.10.001
        • Joshi S.S.
        • Coffin C.S.
        Hepatitis B and pregnancy: virologic and Immunologic Characteristics.
        Hepatol Commun. 2020; 4: 157-171
        • Terrault N.A.
        • Levy M.T.
        • Cheung K.W.
        • et al.
        Viral hepatitis and pregnancy.
        Nat Rev Gastroenterol Hepatol. 2021; 18: 117-130
        • Chen H.L.
        • Lee C.N.
        • Chang C.H.
        • et al.
        Efficacy of maternal tenofovir disoproxil fumarate in interrupting mother-to-infant transmission of hepatitis B virus.
        Hepatology. 2015; 62: 375-386
        • Chen R.
        • Zou J.
        • Long L.
        • et al.
        Safety and efficacy of tenofovir alafenamide fumarate in early-Middle pregnancy for mothers with chronic hepatitis B.
        Front Med (Lausanne). 2021; 8: 796901
        • Kushner T.
        • Shaw P.A.
        • Kalra A.
        • et al.
        Incidence, determinants and outcomes of pregnancy-associated hepatitis B flares: a regional hospital-based cohort study.
        Liver Int. 2018; 38: 813-820
        • Bzowej N.H.
        • Tran T.T.
        • Li R.
        • et al.
        Total Alanine aminotransferase (ALT) flares in pregnant North American women with chronic hepatitis B infection: results from a prospective Observational study.
        Am J Gastroenterol. 2019; 114: 1283-1291
        • Schillie S.
        • Vellozzi C.
        • Reingold A.
        • et al.
        Prevention of hepatitis B virus infection in the United States: recommendations of the advisory Committee on immunization Practices.
        MMWR Recomm Rep. 2018; 67: 1-31
        • Sirilert S.
        • Tongsong T.
        Hepatitis B virus infection in pregnancy: Immunological Response, Natural course and pregnancy outcomes.
        J Clin Med. 2021; 10
        • Huang Q.T.
        • Chen J.H.
        • Zhong M.
        • et al.
        Chronic hepatitis B infection is associated with decreased risk of preeclampsia: a meta-analysis of Observational studies.
        Cell Physiol Biochem. 2016; 38: 1860-1868
        • Jiang R.
        • Wang T.
        • Yao Y.
        • et al.
        Hepatitis B infection and intrahepatic cholestasis of pregnancy: a systematic review and meta-analysis.
        Medicine (Baltimore). 2020; 99: e21416
        • Kushner T.
        • Reau N.
        Changing epidemiology, implications, and recommendations for hepatitis C in women of childbearing age and during pregnancy.
        J Hepatol. 2021; 74: 734-741
        • Rossi R.M.
        • Wolfe C.
        • Brokamp R.
        • et al.
        Reported prevalence of maternal hepatitis C virus infection in the United States.
        Obstet Gynecol. 2020; 135: 387-395
        • Benova L.
        • Mohamoud Y.A.
        • Calvert C.
        • et al.
        Vertical transmission of hepatitis C virus: systematic review and meta-analysis.
        Clin Infect Dis. 2014; 59: 765-773
        • Hillemanns P.
        • Dannecker C.
        • Kimmig R.
        • et al.
        Obstetric risks and vertical transmission of hepatitis C virus infection in pregnancy.
        Acta Obstet Gynecol Scand. 2000; 79: 543-547
        • Hughes B.L.
        • Page C.M.
        • Kuller J.A.
        Hepatitis C in pregnancy: screening, treatment, and management.
        Am J Obstet Gynecol. 2017; 217: B2-B12
        • Cottrell E.B.
        • Chou R.
        • Wasson N.
        • et al.
        Reducing risk for mother-to-infant transmission of hepatitis C virus: a systematic review for the U.S. Preventive Services Task Force.
        Ann Intern Med. 2013; 158: 109-113
        • Money D.
        • Boucoiran I.
        • Wagner E.
        • et al.
        Obstetrical and neonatal outcomes among women infected with hepatitis C and their infants.
        J Obstet Gynaecol Can. 2014; 36: 785-794
        • Wijarnpreecha K.
        • Thongprayoon C.
        • Sanguankeo A.
        • et al.
        Hepatitis C infection and intrahepatic cholestasis of pregnancy: a systematic review and meta-analysis.
        Clin Res Hepatol Gastroenterol. 2017; 41: 39-45
        • Rezk M.
        • Omar Z.
        Deleterious impact of maternal hepatitis-C viral infection on maternal and fetal outcome: a 5-year prospective study.
        Arch Gynecol Obstet. 2017; 296: 1097-1102
        • Hashem M.
        • Jhaveri R.
        • Saleh D.A.
        • et al.
        Spontaneous viral load decline and subsequent clearance of chronic hepatitis C virus in postpartum women Correlates with favorable Interleukin-28B gene Allele.
        Clin Infect Dis. 2017; 65: 999-1005
        • Chappell C.A.
        • Scarsi K.K.
        • Kirby B.J.
        • et al.
        Ledipasvir plus sofosbuvir in pregnant women with hepatitis C virus infection: a phase 1 pharmacokinetic study.
        Lancet Microbe. 2020; 1: e200-e208
        • Doycheva I.
        • Watt K.D.
        • Rifai G.
        • et al.
        Increasing burden of chronic liver disease among Adolescents and young adults in the USA: a Silent epidemic.
        Dig Dis Sci. 2017; 62: 1373-1380
        • Sarkar M.
        • Djerboua M.
        • Flemming J.A.
        NAFLD cirrhosis is rising among childbearing women and is the most common cause of cirrhosis in pregnancy.
        Clin Gastroenterol Hepatol. 2022; 20: e315-e318
        • El Jamaly H.
        • Eslick G.D.
        • Weltman M.
        Systematic review with meta-analysis: non-alcoholic fatty liver disease and the association with pregnancy outcomes.
        Clin Mol Hepatol. 2022; 28: 52-66
        • Ajmera V.H.
        • Terrault N.A.
        • VanWagner L.B.
        • et al.
        Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women.
        J Hepatol. 2019; 70: 126-132
        • Gunderson E.P.
        • Jacobs Jr., D.R.
        • Chiang V.
        • et al.
        Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: a 20-Year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults).
        Diabetes. 2010; 59: 495-504
        • Wang C.W.
        • Grab J.
        • Tana M.M.
        • et al.
        Outcomes of pregnancy in autoimmune hepatitis: a population-based study.
        Hepatology. 2022; 75: 5-12
        • Kothadia J.P.
        • Shah J.M.
        Autoimmune hepatitis and pregnancy.
        StatPearls. StatPearls Publishing. Copyright © 2022, StatPearls Publishing LLC., Treasure Island, FL2022
        • Ludvigsson J.F.
        • Marschall H.U.
        • Hagström H.
        • et al.
        Pregnancy outcome in women undergoing liver biopsy during pregnancy: a nationwide population-based cohort study.
        Hepatology. 2018; 68: 625-633
        • Peters M.G.
        Management of autoimmune hepatitis in pregnant women.
        Gastroenterol Hepatol (N Y). 2017; 13: 504-506
        • Terrabuio D.R.
        • Abrantes-Lemos C.P.
        • Carrilho F.J.
        • et al.
        Follow-up of pregnant women with autoimmune hepatitis: the disease behavior along with maternal and fetal outcomes.
        J Clin Gastroenterol. 2009; 43: 350-356
        • Grønbaek L.
        • Vilstrup H.
        • Jepsen P.
        Pregnancy and birth outcomes in a Danish nationwide cohort of women with autoimmune hepatitis and matched population controls.
        Aliment Pharmacol Ther. 2018; 48: 655-663
        • Braga A.
        • Vasconcelos C.
        • Braga J.
        Autoimmune hepatitis and pregnancy.
        Best Pract Res Clin Obstet Gynaecol. 2020; 68: 23-31
        • El Jamaly H.
        • Eslick G.D.
        • Weltman M.
        Systematic review with meta-analysis: autoimmune hepatitis in pregnancy.
        Scand J Gastroenterol. 2021; 56: 1194-1204
        • Kim M.
        • Rostas S.
        • Gabardi S.
        Mycophenolate fetal toxicity and risk evaluation and mitigation strategies.
        Am J Transplant. 2013; 13: 1383-1389
        • Mussi M.C.L.
        • Nardelli M.J.
        • Santos B.C.
        • et al.
        Pregnancy outcomes in Wilson's disease women: Single-center case series.
        Fetal Pediatr Pathol. 2021; : 1-8https://doi.org/10.1080/15513815.2021.1960940
        • Pinter R.
        • Hogge W.A.
        • McPherson E.
        Infant with severe penicillamine embryopathy born to a woman with Wilson disease.
        Am J Med Genet A. 2004; 128a: 294-298
        • Brewer G.J.
        • Johnson V.D.
        • Dick R.D.
        • et al.
        Treatment of Wilson's disease with zinc. XVII: treatment during pregnancy.
        Hepatology. 2000; 31: 364-370
        • Michalczyk A.
        • Bastow E.
        • Greenough M.
        • et al.
        ATP7B expression in human breast epithelial cells is mediated by lactational hormones.
        J Histochem Cytochem. 2008; 56: 389-399
        • Trivedi P.J.
        • Kumagi T.
        • Al-Harthy N.
        • et al.
        Good maternal and fetal outcomes for pregnant women with primary biliary cirrhosis.
        Clin Gastroenterol Hepatol. 2014; 12: 1179-1185.e1
        • Whelton M.J.
        • Sherlock S.
        Pregnancy in patients with hepatic cirrhosis. Management and outcome.
        Lancet. 1968; 2: 995-999
        • Cauldwell M.
        • Mackie F.L.
        • Steer P.J.
        • et al.
        Pregnancy outcomes in women with primary biliary cholangitis and primary sclerosing cholangitis: a retrospective cohort study.
        Bjog. 2020; 127: 876-884
        • Marchioni Beery R.M.
        • Vaziri H.
        • Forouhar F.
        Primary biliary cirrhosis and primary sclerosing cholangitis: a review featuring a Women's health Perspective.
        J Clin Transl Hepatol. 2014; 2: 266-284
        • Efe C.
        • Kahramanoğlu-Aksoy E.
        • Yilmaz B.
        • et al.
        Pregnancy in women with primary biliary cirrhosis.
        Autoimmun Rev. 2014; 13: 931-935
        • Poupon R.
        • Chrétien Y.
        • Chazouillères O.
        • et al.
        Pregnancy in women with ursodeoxycholic acid-treated primary biliary cirrhosis.
        J Hepatol. 2005; 42: 418-419
        • Gossard A.A.
        • Lindor K.D.
        Pregnancy in a patient with primary sclerosing cholangitis.
        J Clin Gastroenterol. 2002; 35: 353-355
        • Palmela C.
        • Peerani F.
        • Castaneda D.
        • et al.
        Inflammatory bowel disease and primary sclerosing cholangitis: a review of the Phenotype and associated specific features.
        Gut Liver. 2018; 12: 17-29
        • Wellge B.E.
        • Sterneck M.
        • Teufel A.
        • et al.
        Pregnancy in primary sclerosing cholangitis.
        Gut. 2011; 60: 1117-1121
        • Ludvigsson J.F.
        • Bergquist A.
        • Ajne G.
        • et al.
        A population-based cohort study of pregnancy outcomes among women with primary sclerosing cholangitis.
        Clin Gastroenterol Hepatol. 2014; 12: 95-100.e1
        • Chapman R.
        • Fevery J.
        • Kalloo A.
        • et al.
        Diagnosis and management of primary sclerosing cholangitis.
        Hepatology. 2010; 51: 660-678
        • Tolunay H.E.
        • Aydın M.
        • Cim N.
        • et al.
        Maternal and fetal outcomes of pregnant women with hepatic cirrhosis.
        Gastroenterol Res Pract. 2020; 2020: 5819819
        • Stelmach A.
        • Słowik Ł.
        • Cichoń B.
        • et al.
        Esophageal varices during pregnancy in the course of cirrhosis.
        Eur Rev Med Pharmacol Sci. 2020; 24: 9615-9617
        • Zvárová V.
        • Dolina J.
        • Šenkyřík M.
        • et al.
        Liver cirrhosis and pregnancy: a case report and review of literature.
        Vnitr Lek. 2021; 67 (Jaterní cirhóza a těhotenství: kazuistika a přehled literatury): 28-32
        • Westbrook R.H.
        • Yeoman A.D.
        • O'Grady J.G.
        • et al.
        Model for end-stage liver disease score predicts outcome in cirrhotic patients during pregnancy.
        Clin Gastroenterol Hepatol. 2011; 9: 694-699
        • Shaheen A.A.
        • Myers R.P.
        The outcomes of pregnancy in patients with cirrhosis: a population-based study.
        Liver Int. 2010; 30: 275-283
        • Savage C.
        • Patel J.
        • Lepe M.R.
        • et al.
        Transjugular intrahepatic portosystemic shunt creation for recurrent gastrointestinal bleeding during pregnancy.
        J Vasc Interv Radiol. 2007; 18: 902-904
        • Abbas M.A.
        • Stone W.M.
        • Fowl R.J.
        • et al.
        Splenic artery aneurysms: two decades experience at Mayo clinic.
        Ann Vasc Surg. 2002; 16: 442-449
        • Rahim M.N.
        • Pirani T.
        • Williamson C.
        • et al.
        Management of pregnancy in women with cirrhosis.
        United Eur Gastroenterol J. 2021; 9: 110-119
        • Rasheed S.M.
        • Abdel Monem A.M.
        • Abd Ellah A.H.
        • et al.
        Prognosis and determinants of pregnancy outcome among patients with post-hepatitis liver cirrhosis.
        Int J Gynaecol Obstet. 2013; 121: 247-251
        • Wood A.M.
        • Grotegut C.A.
        • Ronald J.
        • et al.
        Identification and management of abdominal Wall varices in pregnancy.
        Obstet Gynecol. 2018; 132: 882-887
        • Flemming J.A.
        • Mullin M.
        • Lu J.
        • et al.
        Outcomes of pregnant women with cirrhosis and their infants in a population-based study.
        Gastroenterology. 2020; 159: 1752-1762.e10
        • Tan J.
        • Surti B.
        • Saab S.
        Pregnancy and cirrhosis.
        Liver Transpl. 2008; 14: 1081-1091