| Diagnosis and management of liver disease in pregnancy. | |
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MedLine Citation:
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PMID: 2405596 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Liver disease in pregnancy is uncommon, acute viral hepatitis being the most frequent. The latter has a normal prognosis in pregnancy, with the possible exception of NANB hepatitis in India and North Africa. Immunization of neonates born of mothers suffering from acute or chronic HBV is essential and effective. Acute fatty liver of pregnancy has a better prognosis than previously thought, perhaps due to diagnosis of milder cases or improved intensive care. Its etiology is still unknown, but metabolic stress may be important. The confusion and overlap of AFLP, the HELLP syndrome, and liver disease of eclampsia suggest common etiological factors. Urgent delivery of the fetus is recommended in AFLP. The related condition of acute liver rupture may be diagnosed by ultrasound. Successful conservative management has been reported. Estrogens are involved in the pathophysiology of ICP, but this does not explain the profound racial differences in incidence. The nature of the sensitivity to estrogens is not understood, although reduced membrane fluidity, which may be counteracted by S-adenosyl-L-methionine, is one possible explanation. The increased fetal loss associated with ICP suggests that treatment should be more energetic than hitherto. In the worst affected individuals, fetal malnutrition secondary to maternal steatorrhea may be an important factor. In general, patients with chronic liver disease have increased maternal and particularly fetal mortality. |
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Authors:
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M L Wilkinson |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Advances in internal medicine Volume: 35 ISSN: 0065-2822 ISO Abbreviation: Adv Intern Med Publication Date: 1990 |
Date Detail:
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Created Date: 1990-03-12 Completed Date: 1990-03-12 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 0370427 Medline TA: Adv Intern Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 289-310 Citation Subset: IM |
Affiliation:
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Gastroenterology Unit, United Medical School, Guy's Hospital, London, England. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Hepatitis, Viral, Human / diagnosis, therapy Humans Liver Diseases* / diagnosis, therapy Pregnancy Pregnancy Complications* / diagnosis, therapy Pregnancy Complications, Infectious / diagnosis, therapy |
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