RT Book, Section A1 Hashemi, Nikroo A1 Ukomado, Chinweike A2 Greenberger, Norton J. A2 Blumberg, Richard S. A2 Burakoff, Robert SR Print(0) ID 1119986083 T1 Hepatic Complications of Pregnancy T2 CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071837729 LK accessmedicine.mhmedical.com/content.aspx?aid=1119986083 RD 2024/03/29 AB ESSENTIAL CONCEPTSMost liver biochemical tests are unchanged during pregnancy.Exceptions are serum albumin, total protein, and bilirubin (decreased) and alkaline phosphatase and cholesterol (increased).Several conditions unique to pregnancy may lead to hepatic impairment:Hyperemesis gravidarum (HG), often in the first trimester, invariably before the 20th week of pregnancy.Intrahepatic cholestasis of pregnancy (ICP), often in the second or third trimester (pruritus and mild liver tests abnormalities).Acute fatty liver disease of pregnancy (AFLP) in the third trimester (nausea and vomiting, abdominal pain, jaundice, oliguria, hypertransaminasemia, hyperbilirubinemia, coagulopathy, thrombocytopenia, renal failure, and hypoglycemia).Preeclampsia (classic triad of hypertension, proteinuria, and edema) and eclampsia (preeclamptic triad plus seizures and coma) in the second or third trimester.HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets), between the start of the third trimester and the immediate postpartum period, often manifesting as weight gain, right upper quadrant pain, edema, and hypertension.