What are liver diseases during pregnancy? And what is their impact on the health of the mother and the fetus? The liver is one of the most important organs in the human body, but it can be significantly affected during pregnancy, leading to serious health problems that may affect both the mother and the fetus. We will shed light on various types of liver diseases that may occur during pregnancy, such as cholestasis of pregnancy. We will explore the causes, symptoms, factors contributing to the development of these diseases, and distinguish between pregnancy sensitivity and cholestasis. We will also present available treatments and precautions that can be taken to prevent liver complications during pregnancy.
What are liver diseases during pregnancy?
Liver diseases during pregnancy include a variety of problems ranging from mild disruptions in liver function to serious symptoms. Some of these symptoms include headaches due to high blood pressure, swelling in the feet, and changes in urine and bile secretion.
Liver diseases during pregnancy can be divided into two groups: diseases that occur coincidentally during pregnancy and those directly caused by pregnancy.
Diseases that occur coincidentally during pregnancy include gallstones, chronic gallbladder inflammation, infections with viruses such as (A, B, C), liver fibrosis, and genetic disorders in metabolic processes such as iron or copper deposition in the liver, as well as autoimmune diseases.
As for diseases directly caused by pregnancy, they include severe morning sickness, intrahepatic cholestasis related to pregnancy, which resolves after childbirth, and other conditions such as preeclampsia, which involves high blood pressure and severe proteinuria with elevated liver enzymes.
Some serious diseases caused by pregnancy may appear, such as acute fatty liver caused by a deficiency of certain enzymes in the fetus, leading to a severe increase in saturated fatty acids in both the fetus and the mother, along with a sharp rise in liver enzymes.
Hepatitis can lead to serious complications such as severe jaundice in urine and blood. In critical cases, it can lead to acute liver coma, which may require terminating the pregnancy in some cases to reduce complications on the mother.
Therefore, Dr. Al Boraie emphasizes the importance of visiting the doctor during pregnancy for ultrasound examinations of the fetus and the liver to avoid serious complications.
Severe morning sickness
Severe morning sickness is a condition characterized by severe nausea and continuous vomiting during pregnancy, which can significantly affect the pregnant woman’s ability to perform her daily tasks, often leading to dehydration, weight loss, and other problems.
Severe morning sickness usually begins in the first trimester of pregnancy, from the fourth to the sixth week, and the symptoms are more severe between the ninth and thirteenth weeks of pregnancy. The situation usually improves around the twentieth week of pregnancy.
The condition of severe morning sickness differs from morning sickness, as morning sickness sometimes includes vomiting and usually disappears between the twelfth and fourteenth weeks of pregnancy. Unlike severe morning sickness, morning sickness is less severe and does not cause severe dehydration problems.
Severe morning sickness is usually diagnosed by the doctor based on the symptoms and the patient’s medical history. Additional diagnostic steps may include blood and urine tests to assess dehydration. The doctor may request other tests to rule out digestive disorders and liver diseases that may be causing vomiting and nausea.
Intrahepatic cholestasis during pregnancy
Intrahepatic cholestasis of pregnancy is one of the liver diseases during pregnancy. Pregnancy hormones, especially estrogen, are believed to affect the function of the gallbladder and liver. When hormone levels rise during pregnancy, the flow of bile from the liver can slow down or stop altogether, causing the accumulation of bile in the liver and its flow into the bloodstream.
Intrahepatic cholestasis during pregnancy occurs in the third trimester when pregnancy hormone levels are at their peak.
The doctor usually diagnoses intrahepatic cholestasis in pregnant women through clinical examination, blood tests, liver function tests, and analysis of bilirubin in the blood.
Symptoms of intrahepatic cholestasis during pregnancy
Severe itching is the main symptom of intrahepatic cholestasis during pregnancy. Pregnant women may experience itching on the palms of their hands or the soles of their feet. It is often worse at night.
Itching is more common during the last three months of pregnancy but can sometimes start early. The condition may worsen as the due date approaches. However, after giving birth, the itching usually disappears within a few days.
Other signs and symptoms of intrahepatic cholestasis during pregnancy may include:
- Yellowing of the skin and the whites of the eyes
- Nausea
- Loss of appetite
- Oily and foul-smelling stool
Complications of intrahepatic cholestasis during pregnancy may occur due to elevated bile levels in the blood. In mothers, the condition may temporarily affect the body’s absorption of fats, leading to a decrease in vitamin K levels associated with blood clotting.
Intrahepatic cholestasis during pregnancy also increases the risk of complications such as preeclampsia and gestational diabetes.
In children, complications of intrahepatic cholestasis during pregnancy can be severe and include:
- Premature birth
- Problems in the fetus’s lungs
- Stillbirth
The difference between pregnancy sensitivity and intrahepatic cholestasis
Itching is a common symptom between sensitivity and intrahepatic cholestasis. There is a difference between pregnancy sensitivity and intrahepatic cholestasis, including:
Pregnancy sensitivity symptoms
- Redness and rash.
- Feeling the warmth of the skin.
- Burning and tingling in the skin.
Intrahepatic cholestasis symptoms:
- Severe itching in the body without any visible rash.
- Itching in areas such as the palm of the hand and the sole of the foot.
- Intensified itching at night.
Itching may be accompanied by severe symptoms such as abdominal pain, nausea, and loss of appetite. Stool color may become pale, and the skin and the whites of the eyes may turn yellow.
These details help distinguish between pregnancy sensitivity and intrahepatic cholestasis. However, in both cases, it is essential to consult a doctor for proper diagnosis and receive appropriate treatment.
Best liver doctor for treating liver diseases during pregnancy
Dr. Mohamed Al Boraie is considered the best doctor for treating liver diseases during pregnancy. He is a liver and gastrointestinal endoscopy consultant, a fellow of the Royal College of Physicians in England, and a member of the American College of Gastroenterology. Currently, Dr. Mohamed Al Boraie is also a lecturer in internal medicine, liver diseases, and the gastrointestinal system at Al-Azhar University Faculty of Medicine in Cairo.
Book your appointment now if you would like to consult with Dr. Mohamed Al Boraie regarding intrahepatic cholestasis during pregnancy and the latest diagnostic and treatment methods.