GI Complications Involving Liver in Pregnancy Flashcards
(15 cards)
describe ICP
bile cannot flow from liver to duodenum caused by either mechanical obstruction or metabolic disturbances in bile formation
what are the risk factors for ICP?
hep C, winter, low vit D, multiple, >35y/o, genetic defects, low selenium
what is usual treatment for ICP
UDCA
what are possible birth outcomes in ICP
preterm, mec stained liquor, NICU, hypoxia, stillbirth
define HELLP syndrome
haemolysis, elevated liver enzymes, low platelet count
describe the pathogenesis of HELLP syndrome
immunological, genetic and environmental, impaired invasion of placenta causing changes in growth factors affecting vasc system in placenta and fetus
what complications occur in HELLP
placental GF and sFLT cause vasoconstriction -> multiorgan microvasc injury, hepatic necrosis -> HELLP and proteinuria
what are the symptoms of HELLP
headaches, RUQ pain, weight gain, N & V, jaundice, visual/cerebral symptoms, pulmonary oedema, renal insufficiency,
what diagnostic results indicate HELLP
liver enzyme abnormalities, ketones/protein/bilirubin in urine, elevated blood urea nitrogen and creatinine
how is HELLP managed?
magnesium sulfate, BP control, plasma exchange therapy, delivery >34K where possible
describe acute fatty liver of pregnancy
unexplained liver failure with N & V, abdo pain, malaise
describe steatosis
process of triglyceride (fat) accumulation in hepatocytes, is reversible but can result in cirrhosis if untreated
what is the cause of steatosis
disordered metabolism of fatty acids by mitochondria in the mother through a mutation
what are the signs of steatosis
jaundice, abdo pain, CNS, GI bleeding, N & V, oliguria, tachycardia, late onset pyrexia
what are the risk factors for steatosis
primip, PET, male fetus, multiple gest, ethnicity, drugs
