| Literature DB >> 31360030 |
Anil Arora1, Ashish Kumar1, Anil C Anand2, Pankaj Puri1, Radha K Dhiman3, Subrat K Acharya2, Kiran Aggarwal4, Neelam Aggarwal5, Rakesh Aggarwal6, Yogesh K Chawla2, Vinod K Dixit7, Ajay Duseja3, Chundamannil E Eapen8, Bhabadev Goswami9, Kanwal Gujral10, Anoop Gupta11, Ankur Jindal12, Premashish Kar13, Krishna Kumari14, Kaushal Madan15, Jaideep Malhotra16, Narendra Malhotra16, Gaurav Pandey6, Uma Pandey17, Ratna D Puri1, Ramesh R Rai18, Padaki N Rao19, Shiv K Sarin12, Aparna Sharma20, Praveen Sharma1, Koticherry T Shenoy21, Karam R Singh22, Shivaram P Singh23, Vanita Suri5, Nirupama Trehanpati12, Manav Wadhawan24.
Abstract
Liver diseases occurring during pregnancy can be serious and can progress rapidly, affecting outcomes for both the mother and fetus. They are a common cause of concern to an obstetrician and an important reason for referral to a hepatologist, gastroenterologist, or physician. Liver diseases during pregnancy can be divided into disorders unique to pregnancy, those coincidental with pregnancy, and preexisting liver diseases exacerbated by pregnancy. A rapid differential diagnosis between liver diseases related or unrelated to pregnancy is required so that specialist and urgent management of these conditions can be carried out. Specific Indian guidelines for the management of these patients are lacking. The Indian National Association for the Study of the Liver (INASL) in association with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) had set up a taskforce for development of consensus guidelines for management of patients with liver diseases during pregnancy, relevant to India. For development of these guidelines, a two-day roundtable meeting was held on 26-27 May 2018 in New Delhi, to discuss, debate, and finalize the consensus statements. Only those statements that were unanimously approved by most members of the taskforce were accepted. The primary objective of this review is to present the consensus statements approved jointly by the INASL and FOGSI for diagnosing and managing pregnant women with liver diseases. This article provides an overview of liver diseases occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and the recommended treatment options.Entities:
Keywords: ABCB4, ATP-binding cassette subfamily B member 4; AFLP, Acute fatty liver of pregnancy; ALF, Acute liver failure; ALP, Alkaline phosphatase; ALT, Alanine transferase; ART, Antiretroviral therapy; AST, Aspartate aminotransferase; BCS, Budd-Chiari syndrome; CT, Computerized tomography; DIC, Disseminated intravascular coagulation; DNA, Deoxyribonucleic acid; DPTA, Diethylenetriamine pentaacetic acid; ERCP, Endoscopic retrograde cholangiopancreatography; FDA, Food and Drug Administration; FOGSI, Federation of Obstetric and Gynaecological Societies of India; GGT, Gamma-glutamyl transpeptidase; GI, Gastrointestinal; GRADE, Grading of Recommendations Assessment Development and Evaluation; HBIG, Hepatitis B immune globulin; HBV, Hepatitis B virus; HBeAg, Hepatitis B envelope antigen; HBsAg, Hepatitis B surface antigen; HCV, Hepatitis C virus; HELLP syndrome; HELLP, Hemolysis, elevated liver enzymes, low platelet count; HG, Hyperemesis gravidarum; HIV, Human immunodeficiency virus; HV, Hepatic vein; ICP, Intrahepatic cholestasis of pregnancy; INASL, Indian National Association for the Study of Liver; IVF, In vitro fertilization; LFT, Liver function test; MDR, Multidrug resistance; MRI, Magnetic resonance imaging; MTCT, Mother-to-child transmission; NA, Nucleos(t)ide analog; PIH, Pregnancy-induced hypertension; PT, Prothrombin time; PUQE, Pregnancy-Unique Quantification of Emesis; PegIFN, Pegylated interferon; RNA, Ribonucleic acid; TAF, Tenofovir alafenamide; TDF, Tenofovir disoproxil fumarate; TIPS, Transjugular intrahepatic portosystemic shunt; UDCA, Ursodeoxycholic acid; UGI, Upper gastrointestinal; ULN, Upper limit of normal; acute fatty liver of pregnancy; hyperemesis gravidarum; intrahepatic cholestasis of pregnancy; liver diseases in pregnancy
Year: 2019 PMID： 31360030 PMCID： PMC6637074 DOI： 10.1016/j.jceh.2019.02.007
Source DB: PubMed Journal: J Clin Exp Hepatol ISSN： 0973-6883