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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2022№11
Functional disorders of the liver...

Functional disorders of the liver in the first trimester of pregnancy

DOI
https://dx.doi.org/10.18565/aig.2022.11.14-22

Kryshnia M.A., Mozgovaya E.V.

1) Multidisciplinary Medical Holding “SM-Clinic”, St. Petersburg, Russia; 2) D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia; 3) St. Petersburg State University, St. Petersburg, Russia
Any abnormal liver function can simultaneously present with the onset of pregnancy. This may be a pre-existing chronic liver disease or liver dysfunction associated with pregnancy. Consultation for liver disease in pregnancy is a challenge for both the hepatologist and gynecologist, since the normal physiological changes during pregnancy can mimic chronic liver disease. Pregnancy-specific liver diseases are the main causes of abnormal tests of the hepatic panel. In this case, as much as 3% of all pregnant women in developed countries suffer from liver diseases to unrelated pregnancy. The main factors determining the prognosis of the course of pregnancy for the mother are the type of liver disease and the degree of synthetic, metabolic, and excretory liver dysfunctions. This paper deals with a systematic approach to diagnosing and treating pregnancy-specific liver diseases in the first trimester, which includes an understanding of normal outcomes during pregnancy, exclusion of liver diseases nonspecific to pregnancy, consideration of the early onset of blood biochemical changes, and use of clinical data for early diagnosis and timely treatment.
Conclusion: The studied data on the etiology and pathogenesis, diagnosis and principles of treatment of functional disorders of the liver in the first trimester of pregnancy can serve as a reason for further in-depth studies of hepatopathy in order to expand the understanding of the prevalence and etiopathogenesis, prediction and drug correction of this pathology for the prevention of maternal and perinatal morbidity.

Keywords

liver diseases
pregnancy
hyperemesis gravidarum
drug-induced hepatopathies
non-alcoholic fatty liver disease
Full text (in Russian)

References

  1. García-Romero C.S., Guzman C., Cervantes A., Cerbón M. Liver disease in pregnancy: medical aspects and their implications for mother and child. Ann. Hepatol. 2019; 18(4): 553-62. https://dx.doi.org/10.1016/j.aohep.2019.04.009.
  2. Westbrook R.H., Dusheiko G., Williamson C. Pregnancy and liver disease. J. Hepatol. 2016; 64(4): 933-45. https://dx.doi.org/10.1016/j.jhep.2015.11.030.
  3. Tran T.T., Ahn J., Reau N.S. ACG clinical guideline: liver disease and pregnancy. Am. J. Gastroenterol. 2016; 111(2): 176-94; quiz 196.https://dx.doi.org/10.1038/ajg.2015.430.
  4. Lee S.M., Park J.S., Han Y.J., Kim W. Elevated alanine aminotransferase in early pregnancy and subsequent development of gestational diabetes and preeclampsia. J. Korean Med. Sci. 2020; 35(26): e198. https://dx.doi.org/10.3346/jkms.2020.35.e198.
  5. Cho G.J., Kim H.Y., Park J.H., Ahn K.H., Hong S.C., Oh M.J., Kim H.J. Prepregnancy liver enzyme levels and risk of preeclampsia in a subsequent pregnancy: A population-based cohort study. Liver Int. 2018; 38(5): 949-54. https://dx.doi.org/10.1111/liv.13617.
  6. Пальгова Л.К., Мозговая Е.В., Жесткова Н.В. Болезни печени, связанные с беременностью: Клинические рекомендации общества акушеров-гинекологов Санкт-Петербурга и СЗФО и Санкт-Петербургского общества гастроэнтерологов, гепатологов и диетологов. СПб.: Эко-Вектор; 2017. 47с. [Palgova L.K, Mozgovaya E.V., Zhestkova N.V. Liver diseases associated with pregnancy: Clinical recommendations of the Society of Obstetricians and Gynecologists of St. Petersburg and the Northwestern Federal District and the St. Petersburg Society of Gastroenterologists, Hepatologists and Nutritionists. St. Petersburg: Eco-Vector; 2017. 47 p. (in Russian)].
  7. Mikolasevic I., Filipec-Kanizaj T., Jakopcic I., Majurec I., Brncic-Fischer A., Sobocan N. et al. Liver disease during pregnancy: a challenging clinical issue. Med. Sci. Monit. 2018; 24: 4080-90. https://dx.doi.org/10.12659/MSM.907723.
  8. Подымова С.Д. Болезни печени. Руководство для врачей. М.: МИА; 2018: 841-3. [Podymova, S.D. Liver diseases: A guide for doctors. 5th ed., reprint. and add. M.: LLC "Medical Information Agency"; 2018: 841-83. (in Russian)].
  9. Committee Opinion No. 723: Guidelines for diagnostic imaging during pregnancy and lactation. Obstet. Gynecol. 2017; 130(4): e210-6.https://dx.doi.org/10.1097/AOG.0000000000002355.
  10. Henry F., Quatresooz P., Valverde-Lopez J.C., Piérard G.E. Blood vessel changes during pregnancy: a review. Am. J. Clin. Dermatol. 2006; 7(1): 6569.https://dx.doi.org/10.2165/00128071-200607010-00006.
  11. Новрузова Д.Р., Соснова Е.А. Особенности состояния гепатобилиарной системы при физиологическом течении беременности и на фоне приёма лекарственных препаратов. Архив акушерства и гинекологии им. В.Ф. Снегирева. 2018; 5(2): 60-4. https://dx.doi.org/10.18821/2313-8726-2018-5-2-60-64. [Novruzova D.R., Sosnova E.A. Features of the state of the hepatobiliary system during the physiological course of pregnancy and against the background of taking medications. Archive of Obstetrics and Gynecology named after V.F. Snegirev. 2018; 5(2): 60-4. (in Russian)].https://dx.doi.org/10.18821/2313-8726-2018-5-2-60-64.
  12. Lee N.M., Brady C.W. Liver disease and pregnancy. World J. Gastroenterol. 2009; 15(8): 897-906. https://dx.doi.org/10.3748/wjg.15.897.
  13. Kwo P.Y., Cohen S.M., Lim J.K. ACG clinical guideline: evaluation of abnormal liver chemistries. Am. J. Gastroenterol. 2017; 112(1): 18-35.https://dx.doi.org/10.1038/ajg.2016.517.
  14. Terrault N.A., Levy M.T., Cheung K.W., Jourdain G. Viral hepatitis and preg-nancy. Nat. Rev. Gastroenterol. Hepatol. 2021; 18(2): 117-30.https://dx.doi.org/10.1038/s41575-020-00361-w.
  15. Пальгова Л.К., Мозговая Е.В., Жесткова Н.В., Вишневская Е.Е., Пазенко Е.В. Болезни печени и беременность. Анализ актуальных клинических рекомендаций и собственный опыт. Часть первая. Болезни печени, связанные с беременностью. Экспериментальная и клиническая гастроэнтерология. 2018; 151(3): 105-14. [Palgova L.K., Mozgovaya E.V., Zhestkova N.V., Vishnevskaya E.E., Pazenko E.V. Liver diseases and pregnancy. Analysis of current clinical recommendations and own experience. Part one. Liver diseases associated with pregnancy. Experimental and clinical gastroenterology. 2018;151(3):105-14. (in Russian)].
  16. Приказ Минздрава России от 20.10.2020 N1130н "Об утверждении Порядка оказания медицинской помощи по профилю "акушерство и гинекология"(зарегистрирован в Минюсте России 12.11.2020 N 60869). [Order of the Ministry of Health of the Russian Federation dated 20.10.2020 N1130n "On approval of the Procedure for providing medical care in the profile "obstetrics and gynecology" (registered with the Ministry of Justice of the Russian Federation on 12.11.2020 N 60869).(in Russian)].
  17. Ghany M.G., Morgan T.R.; AASLD-IDSA Hepatitis C Guidance Panel. Hepatitis C guidance 2019 update: AASLD-IDSA recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology. 2020; 71(2): 686-721. https://dx.doi.org/10.1002/hep.31060.
  18. Ma K., Berger D., Reau N. Liver diseases during pregnancy. Clin. Liver Dis. 2019; 23(2): 345-61. https://dx.doi.org/10.1016/j.cld.2018.12.013.
  19. Popa S.L., Barsan M., Caziuc A., Pop C., Muresan L., Popa L.C., Perju-Dumbrava L. Life-threatening complications of hyperemesis gravidarum. Exp. Ther. Med. 2021; 21(6): 642. https://dx.doi.org/10.3892/etm.2021.10074.
  20. Jansen L.A.W., Koot M., Hooft J., Dean C., Bossuyt P.M.M., Ganzevoort W. et al. The windsor definition for hyperemesis gravidarum: a multistakeholder international consensus definition. Eur. J. Obstet. Gynecol. Reprod. Biol. 2021; 266: 15-22. https://dx.doi.org/10.1016/j.ejogrb.2021.09.004.
  21. Ahmed K.T., Almashhrawi A.A., Rahman R.N., Hammoud G.M., Ibdah J.A. Liver diseases in pregnancy: diseases unique to pregnancy. World J. Gastroenterol. 2013; 19(43): 7639-46. https://dx.doi.org/10.3748/wjg.v19.i43.7639.
  22. Bustos M., Venkataramanan R., Caritis S. Nausea and vomiting of pregnancy - What's new? Auton. Neurosci. 2017; 202: 62-72. https://dx.doi.org/10.1016/j.autneu.2016.05.002.
  23. Вишневская Е.Е., Мозговая Е.В., Петрова Н.Н. Характеристика личностно-психологических особенностей психического состояния беременных с ранним токсикозом. Журнал акушерства и женских болезней. 2014; 63(5): 22-8. https://dx.doi.org/10.17816/JOWD63522-28. [Vishnevskaya E.E., Mozgovaya E.V., Petrova N.N. The characteristics of personal and psychological factors and mental condition of pregnant women with early toxemia. Journal of obstetrics and women's diseases. 2014; 63(5): 22-8. (in Russian)].https://dx.doi.org/10.17816/JOWD63522-28.
  24. Ng Q.X., Venkatanarayanan N., De Deyn M.L.Z.Q., Ho C.Y.X., Mo Y., Yeo W.S. A meta-analysis of the association between Helicobacter pylori (H.pylori) infection and hyperemesis gravidarum. Helicobacter. 2018; 23(1).https://dx.doi.org/10.1111/hel.12455.
  25. Heitmann K., Nordeng H., Havnen G.C., Solheimsnes A., Holst L. The burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again - results from a cross-sectional study. BMC Pregnancy Childbirth. 2017; 17(1): 75.https://dx.doi.org/10.1186/s12884-017-1249-0.
  26. Birkeland E., Stokke G., Tangvik R.J., Torkildsen E.A., Boateng J., Wollen A.L. et al. Norwegian PUQE (pregnancy-unique quantification of emesis and nausea) identifies patients with hyperemesis gravidarum and poor nutritional intake: a prospective cohort validation study. PLoS One. 2015; 10(4): e0119962.https://dx.doi.org/10.1371/journal.pone.0119962.
  27. Boelig R.C., Barton S.J., Saccone G., Kelly A.J., Edwards S.J., Berghella V. Interventions for treating hyperemesis gravidarum: a Cochrane systematic review and metaa-nalysis. J. Matern. Fetal Neonatal Med. 2018; 31(18): 2492-505. https://dx.doi.org/10.1080/14767058.2017.1342805.
  28. Oliveira L.G., Capp S.M., You W.B., Riffenburgh R.H., Carstairs S.D. Ondansetron compared with doxylamine and pyridoxine for treatment of nausea in pregnancy: a randomized controlled trial. Obstet. Gynecol. 2014; 124(4): 735-42.https://dx.doi.org/10.1097/AOG.0000000000000479.
  29. Italian Association for the Study of the Liver (AISF). AISF position paper on liver disease and pregnancy. Dig. Liver Dis. 2016; 48(2): 120-37.https://dx.doi.org/10.1016/j.dld.2015.11.004.
  30. Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 189: nausea and vomiting of pregnancy. Obstet. Gynecol. 2018; 131(1): e15-30. https://dx.doi.org/10.1097/AOG.0000000000002456.
  31. Royal College of Obstetricians and Gynaecologists. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum: Green-Top Guideline No. 69. June 16 2016. https://dx.doi.org/10.1080/14767058.2017.1342805.
  32. Sarkar M., Brady C.W., Fleckenstein J., Forde K.A., Khungar V., Molleston J.P. et al. Reproductive health and liver disease: practice guidance by the American association for the study of liver diseases. Hepatology. 2021; 73(1): 318-65. https://dx.doi.org/10.1002/hep.31559.
  33. Popa S.L., Barsan M., Caziuc A., Pop C., Muresan L., Popa L.C., Perju-Dumbrava L. Life-threatening complications of hyperemesis gravidarum. Exp. Ther. Med. 2021; 21(6): 642. https://dx.doi.org/10.3892/etm.2021.10074.
  34. Veenendaal M.V.E., van Abeelen A.F.M., Painter R.C., van der Post J.A.,Roseboom T.J. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. BJOG. 2011; 118(11): 1302-13.https://dx.doi.org/10.1111/j.1471-0528.2011.03023.x.
  35. Mullin P.M., Ching C., Schoenberg F., MacGibbon K., Romero R., Goodwin T.M., Fejzo M.S. Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum. J. Matern. Fetal Neonatal Med. 2012; 25(6): 632-6. https://dx.doi.org/10.3109/14767058.2011.598588.
  36. Jayaraman T., Lee Y.Y., Chan W.K., Mahadeva S. Epidemiological differences of common liver conditions between Asia and the West. JGH Open. 2020; 4(3): 332-9. https://dx.doi.org/10.1002/jgh3.12275.
  37. Reuben A., Koch D.G., Lee W.M.; Acute Liver Failure Study Group. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. Hepatology. 2010; 52(6): 2065-76. https://dx.doi.org/10.1002/hep.23937.
  38. Hoofnagle J.H., Björnsson E.S. Drug-induced liver injury - types and phenotypes. N. Engl. J. Med. 2019; 381(3): 264-73. https://dx.doi.org/10.1056/NEJMra1816149.
  39. Fontana R.J. Pathogenesis of idiosyncratic drug-induced liver injury and clinical perspectives. Gastroenterology. 2014; 146(4): 914-28.https://dx.doi.org/10.1053/j.gastro.2013.12.032.
  40. Jeong H. Altered drug metabolism during pregnancy: hormonal regulation of drug-metabolizing enzymes. Expert Opin. Drug Metab. Toxicol. 2010; 6(6): 689-99. https://dx.doi.org/10.1517/17425251003677755.
  41. Toyoda Y., Endo S., Tsuneyama S., Miyashita T., Yano A., Fukami T. et al. Mechanism of exacerbative effect of progesterone on drug-induced liver injury. Toxicol. Sci. 2012; 126(1): 16-27. https://dx.doi.org/10.1093/toxsci/kfr326.
  42. Sandhu N., Navarro V. Drug-induced liver injury in GI practice. Hepatol. Commun. 2020; 4(5): 631-45. https://dx.doi.org/10.1002/hep4.1503.
  43. Kopylov U., Avidan B., Papageorgiou N.P., Katz L.H., Sivan E., Zimlichman E. et al. Idiopathic liver function test abnormality in pregnancy is associated with assisted reproduction techniques. Fertil. Steril. 2013; 99(2): 377-81.https://dx.doi.org/10.1016/j.fertnstert.2012.09.015.
  44. Aithal G.P., Watkins P.B., Andrade R.J., Larrey D., Molokhia M., Takikawa H. et al. Case definition and phenotype standardization in drug-induced liver injury. Clin. Pharmacol. Ther. 2011; 89(6): 806-15. https://dx.doi.org/10.1038/clpt.2011.58.
  45. European Association for the Study of the Liver; Clinical Practice Guideline Panel: Chair; Panel members; EASL Governing Board representative. EASL clinical practice guidelines: drug-induced liver injury. J. Hepatol. 2019; 70(6): 1222-61. https://dx.doi.org/10.1016/j.jhep.2019.08.008.
  46. Борисова И.В., Пальгова Л.К., Тарасова М.А., Жесткова Н.В. Применение эссенциальных фосфолипидов в лечении лекарственных поражений печени при беременности. Журнал акушерства и женских болезней. 2017; 66(2): 14-23. https://dx.doi.org/10.17816/JOWD66214-23. [Borisova I.V., Palgova L.K., Tarasova M.A., Zhestkova N.V. The use of essential phospholipids in the treatment of medicinal liver lesions during pregnancy. Journal of Obstetrics and Women's Diseases. 2017; 66(2): 14-23. (in Russian)]. https://dx.doi.org/10.17816/JOWD66214-23.
  47. Макаров И.О., Боровкова Е.И., Казаков Р.Д. Распространенность неалкогольной жировой болезни печени у беременных с ожирением. Акушерство, гинекология и репродукция. 2012; 6(4): 18-22. [Makarov I.O., Borovkova E.I., Kazakov R.D. Prevalence of non-alcoholic fatty liver disease in pregnant women with obesity. Obstetrics, gynecology and reproduction. 2012; 6(4): 18-22. (in Russian)].
  48. Рзаева Р.Н., Мозговая Е.В., Пальгова Л.К., Прокопенко В.М., Тумасова Ж.Н. Особенности течения беременности у женщин при стеатозе печени и ожирении. Журнал акушерства и женских болезней. 2013; 62(6): 47-54. [Rzaeva R.N., Mozgovaya E.V., Palgova L.K., Prokopenko V.M., Tumasova Zh.N. Features of pregnancy in women with liver steatosis and obesity. Journal of Obstetrics and Women's Diseases. 2013; 6: 47-54.(in Russian)].
  49. Никитин И.Г. Скрининговая программа по выявлению распространенности неалкогольной жировой болезни печени и определению факторов риска развития заболевания. Российские медицинские вести. 2010; 15(1): 41-6. [Nikitin I.G. Screening program to identify the prevalence of non-alcoholic fatty liver disease and to determine risk factors for the development of the disease. Russian Medical News. 2010; 1: 41-6. (in Russian)].
  50. Younossi Z.M., Koenig A.B., Abdelatif D., Fazel Y., Henry L., Wymer M. Global epidemiology of nonalcoholic fatty liver disease–metanalytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016; 64(1): 73-84.https://dx.doi.org/10.1002/hep.28431.
  51. Sarkar M., Grab J., Dodge J., Gunderson E.P., Rubin J., Irani R.A. et al. Non-alcoholic fatty liver disease in pregnancy is associated with adverse maternal and perinatal outcomes J. Hepatol. 2020; 73(3): 516-22.https://dx.doi.org/10.1016/j.jhep.2020.03.049.
  52. Schulman I.H., Zeng Q. Link between the renin–angiotensin system and insulin resistance: implications for cardiovascular disease. Vasc. Med. 2012; 17(5): 330-41. https://dx.doi.org/10.1177/1358863X12450094.
  53. Lee S.M., Kim B.J., Koo J.N., Norwitz E.R., Oh I.H., Kim S.M. et al. Nonalcoholic fatty liver disease is a risk factor for large-for-gestational-age birthweight. PLoS One. 2019; 14(8): e0221400. https://dx.doi.org/10.4236/cus.2018.61002.
  54. Park J.Y., Kim W.J., Chung Y.H., Kim B., Park Y., Park I.Y., Ko H.S. Association between pregravid liver enzyme levels and gestational diabetes in twin pregnancies: a secondary analysis of national cohort study. Sci. Rep. 2021; 11(1): 18695. https://dx.doi.org/10.1038/s41598-021-98180-9.
  55. Hagström H., Höijer J., Ludvigsson J.F., Bottai M., Ekbom A., Hultcrantz R, et al. Adverse outcomes of pregnancy in women with non-alcoholic fatty liver disease. Liver Int. 2016; 36(2): 268-74. https://dx.doi.org/10.1111/liv.12902.
  56. Chalasani N., Younossi Z., Lavine J.E., Charlton M., Cusi K., Rinella M. et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018; 67(1): 328-57. https://dx.doi.org/10.1002/hep.29367.
  57. Xian Y.X., Weng J.P., Xu F. MAFLD vs. NAFLD: shared features and potential changes in epidemiology, pathophysiology, diagnosis, and pharmacotherapy. Chin. Med. J. (Engl.). 2020; 134(1): 8-19. https://dx.doi.org/10.1097/CM9.0000000000001263.

Received 24.05.2022

Accepted 13.09.2022

About the Authors

Marina A. Kryshnia, obstetrician-gynecologist, multidisciplinary medical holding «SM-Clinic», +7(963)317-10-70, Marina._k@mail.ru,
192288, Russia, St. Petersburg, Dunaiskiy Ave, 47.
Elena V. Mozgovaya, Dr. Med. Sci., Head of the Department of Obstetrics and Perinatology, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, 199034, Mendeleevskaya linia, 3, St. Petersburg, Russia; Professor at the Department of Obstetrics, Gynecology and Reproductology, Medical Faculty, St. Petersburg State University, Russia, St. Petersburg, V.O., 21 Line, 8а, +7(911)929-99-47, elmozg@ mail.ru, WOS Research ID L-1432-2017,
Scopus Author ID 24822403200, https://orcid.org/0000-0002-6460-6816, SPIN 5622-5674.

Authors’ contributions: Mozgovaya E.V., Kryshnia M.A. – concept and design of the investigation; material collection and processing, writing the text; Mozgovaya E.V. – editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has been performed at the D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology within the framework of state funding on Federal Tax Office topic No. FGWN-2022-0004.
For citation: Kryshnia M.A., Mozgovaya E.V.
Functional disorders of the liver in the first trimester of pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 11: 14-22 (in Russian)
https://dx.doi.org/10.18565/aig.2022.11.14-22

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