Pregnancy Related Liver Disease - Hyperemesis gravidarum (HG)
Liver Illness
At a glance
- Pregnancy can result in a number of liver diseases
- Symptoms vary considerably between each illness
- Treatment and prognosis are dependent on the specific disease, but, in general, the outcome is positive for both mother and baby
What is it?
A spectrum of liver diseases can affect women both during pregnancy and following delivery. Four pregnancy-specific liver diseases include:
- Intrahepatic cholestasis of pregnancy (ICP)
- Acute fatty liver disease of pregnancy (AFLDP)
- Haemolysis elevated liver enzymes low platelets (HELLP) syndrome
- Hyperemesis gravidarum (HG)
Hyperemesis gravidarum (HG) describes severe and debilitating nausea and vomiting of early pregnancy which results in weight loss and dehydration. Abnormal or elevated liver function tests (LFTs) occur in half of mothers affected and jaundice sometimes develops.
Typical symptoms
Symptoms of nausea and vomiting are common to most women in the first trimester of pregnancy but in HG, this is much more extreme and unrelenting. Jaundice is an indicator of liver of gall bladder dysfunction.
Diagnosis
By the exclusion of other liver diseases or gastroenteritis / food poisoning, HG is diagnosed as a pregnancy-related liver disease.
Incidence
HG occurs in about 0.3% to 3.6% of pregnancies, with abnormal or elevated LFTs diagnosed in approximately 50% of those cases.
Treatment
Treatment focuses on management of the symptoms including anti-nausea medication and IV fluids to reduce nausea and relieve dehydration, respectively. As HG occurs in the first and second trimesters of pregnancy, HG is resolved by week 20, in most cases.
Prognosis
Invariably, both the mother and baby are not harmed or affected by HG in the long term. Abnormal LFTs will return to normal. HG will commonly recur in subsequent pregnancies for women who have experienced it in their first.
