Liver disease in pregnancy

The presence of abnormal liver function is common in pregnancy. It can be a challenge to elucidate the cause. The history and clinical assessment provide useful tools for distinguishing between pregnancy-related causes, such as pre-eclampsia, acute fatty liver of pregnancy and obstetric cholestasis, and non pregnancy-related causes such as non-alcoholic fatty liver disease, acute viral infection, autoimmune liver disease and Budd–Chiari syndrome. Pregnancy may also affect the natural course of liver conditions, for example, by increasing the risk of haemorrhage from a hepatic adenoma, or the severity of hepatitis E infection. It is important for clinicians to be aware of the impact that liver disorders and the drugs used to treat them have on pregnancy and to understand the influence of pregnancy on specific liver disorders.