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Abnormal liver function tests during pregnancy

MedGen UID:
892927
Concept ID:
C4021883
Finding
Synonym: Abnormal liver function tests during pregnancy, resolves postpartum
 
HPO: HP:0200148

Term Hierarchy

Conditions with this feature

Cholestasis, intrahepatic, of pregnancy, 1
MedGen UID:
762759
Concept ID:
C3549845
Disease or Syndrome
Intrahepatic cholestasis of pregnancy is a reversible form of cholestasis that occurs most often in the third trimester of pregnancy and recurs in 45 to 70% of subsequent pregnancies. Symptoms include pruritus, jaundice, increased serum bile salts, and abnormal liver enzymes, all of which resolve rapidly after delivery. However, the condition is associated with fetal complications, including placental insufficiency, premature labor, fetal distress, and intrauterine death. Some women with ICP may also be susceptible to oral contraceptive-induced cholestasis (OCIC) (summary by Pasmant et al., 2012). Genetic Heterogeneity of Intrahepatic Cholestasis of Pregnancy See also ICP3 (614972), caused by mutation in the ABCB4 gene (171060).
Cholestasis, intrahepatic, of pregnancy, 3
MedGen UID:
767155
Concept ID:
C3554241
Disease or Syndrome
Intrahepatic cholestasis of pregnancy is a reversible form of cholestasis that occurs most often in the third trimester of pregnancy and recurs in 45 to 70% of subsequent pregnancies. Symptoms include pruritus, jaundice, increased serum bile salts, and abnormal liver enzymes, all of which resolve rapidly after delivery. However, the condition is associated with fetal complications, including placental insufficiency, premature labor, fetal distress, and intrauterine death. Women with ICP are also susceptible to oral contraceptive-induced cholestasis (OCIC). Ursodeoxycholic acid (UDCA) is an effective treatment for conditions caused by ABCB4 mutations (summary by Pasmant et al., 2012). Mutation in the ABCB4 gene accounts for about 15% of ICP cases (summary by Ziol et al., 2008). For a discussion of genetic heterogeneity of ICP, see ICP1 (147480).

Professional guidelines

PubMed

Dionne-Odom J, Cozzi GD, Franco RA, Njei B, Tita ATN
Am J Obstet Gynecol 2022 Mar;226(3):335-346. Epub 2021 Sep 10 doi: 10.1016/j.ajog.2021.09.002. PMID: 34516961Free PMC Article
Maness DL, Riley E, Studebaker G
Am Fam Physician 2021 Dec 1;104(6):626-635. PMID: 34913652
Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, Simonneau G, Peacock A, Vonk Noordegraaf A, Beghetti M, Ghofrani A, Gomez Sanchez MA, Hansmann G, Klepetko W, Lancellotti P, Matucci M, McDonagh T, Pierard LA, Trindade PT, Zompatori M, Hoeper M; ESC Scientific Document Group
Eur Heart J 2016 Jan 1;37(1):67-119. Epub 2015 Aug 29 doi: 10.1093/eurheartj/ehv317. PMID: 26320113

Recent clinical studies

Etiology

Dionne-Odom J, Cozzi GD, Franco RA, Njei B, Tita ATN
Am J Obstet Gynecol 2022 Mar;226(3):335-346. Epub 2021 Sep 10 doi: 10.1016/j.ajog.2021.09.002. PMID: 34516961Free PMC Article
Mawson AR, Croft AM
Int J Environ Res Public Health 2019 Sep 22;16(19) doi: 10.3390/ijerph16193543. PMID: 31546693Free PMC Article
Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, Nelson NP
MMWR Recomm Rep 2018 Jan 12;67(1):1-31. doi: 10.15585/mmwr.rr6701a1. PMID: 29939980Free PMC Article
Williamson C, Geenes V
Obstet Gynecol 2014 Jul;124(1):120-133. doi: 10.1097/AOG.0000000000000346. PMID: 24901263
Pathak B, Sheibani L, Lee RH
Obstet Gynecol Clin North Am 2010 Jun;37(2):269-82. doi: 10.1016/j.ogc.2010.02.011. PMID: 20685553

Diagnosis

Dickey AK, Naik H, Keel SB, Levy C, Beaven SW, Elmariah SB, Erwin AL, Goddu RJ, Hedstrom K, Leaf RK, Kazamel M, Mazepa M, Philpotts LL, Quigley J, Raef H, Rudnick SR, Saberi B, Thapar M, Ungar J, Wang B, Balwani M; Porphyrias Consortium of the Rare Diseases Clinical Research Network
J Am Acad Dermatol 2023 Dec;89(6):1227-1237. Epub 2022 Aug 27 doi: 10.1016/j.jaad.2022.08.036. PMID: 36041558Free PMC Article
Katarey D, Westbrook RH
Best Pract Res Clin Obstet Gynaecol 2020 Oct;68:12-22. Epub 2020 Apr 7 doi: 10.1016/j.bpobgyn.2020.03.013. PMID: 32381461
Braga A, Vasconcelos C, Braga J
Best Pract Res Clin Obstet Gynaecol 2020 Oct;68:23-31. Epub 2020 Mar 16 doi: 10.1016/j.bpobgyn.2020.03.007. PMID: 32376296
Ma K, Berger D, Reau N
Clin Liver Dis 2019 May;23(2):345-361. Epub 2019 Feb 26 doi: 10.1016/j.cld.2018.12.013. PMID: 30947881
Williamson C, Geenes V
Obstet Gynecol 2014 Jul;124(1):120-133. doi: 10.1097/AOG.0000000000000346. PMID: 24901263

Therapy

Dionne-Odom J, Cozzi GD, Franco RA, Njei B, Tita ATN
Am J Obstet Gynecol 2022 Mar;226(3):335-346. Epub 2021 Sep 10 doi: 10.1016/j.ajog.2021.09.002. PMID: 34516961Free PMC Article
Society for Maternal-Fetal Medicine (SMFM). Electronic address: [email protected], Lee RH, Mara Greenberg, Metz TD, Pettker CM
Am J Obstet Gynecol 2021 Feb;224(2):B2-B9. Epub 2020 Nov 13 doi: 10.1016/j.ajog.2020.11.002. PMID: 33197417
Schillie S, Vellozzi C, Reingold A, Harris A, Haber P, Ward JW, Nelson NP
MMWR Recomm Rep 2018 Jan 12;67(1):1-31. doi: 10.15585/mmwr.rr6701a1. PMID: 29939980Free PMC Article
Rac MW, Revell PA, Eppes CS
Am J Obstet Gynecol 2017 Apr;216(4):352-363. Epub 2016 Dec 9 doi: 10.1016/j.ajog.2016.11.1052. PMID: 27956203
Lambert J
Curr Probl Dermatol 2016;50:164-72. Epub 2016 Aug 23 doi: 10.1159/000446087. PMID: 27578086

Prognosis

Inoue T, Watanabe T, Tanaka Y
Clin Mol Hepatol 2023 Oct;29(4):851-868. Epub 2023 Mar 9 doi: 10.3350/cmh.2022.0434. PMID: 36891607Free PMC Article
Zhou Q, Kang G, Jiang P, Qiao R, Lam WKJ, Yu SCY, Ma ML, Ji L, Cheng SH, Gai W, Peng W, Shang H, Chan RWY, Chan SL, Wong GLH, Hiraki LT, Volpi S, Wong VWS, Wong J, Chiu RWK, Chan KCA, Lo YMD
Proc Natl Acad Sci U S A 2022 Nov;119(44):e2209852119. Epub 2022 Oct 26 doi: 10.1073/pnas.2209852119. PMID: 36288287Free PMC Article
Choon SE, Navarini AA, Pinter A
Am J Clin Dermatol 2022 Jan;23(Suppl 1):21-29. Epub 2022 Jan 21 doi: 10.1007/s40257-021-00654-z. PMID: 35061227Free PMC Article
Maglie R, Quintarelli L, Verdelli A, Fabbri P, Antiga E, Caproni M
G Ital Dermatol Venereol 2019 Jun;154(3):286-298. Epub 2018 Oct 29 doi: 10.23736/S0392-0488.18.06159-X. PMID: 30375214
Shekhar S, Diddi G
Taiwan J Obstet Gynecol 2015 Oct;54(5):475-82. doi: 10.1016/j.tjog.2015.01.004. PMID: 26522095

Clinical prediction guides

Inoue T, Watanabe T, Tanaka Y
Clin Mol Hepatol 2023 Oct;29(4):851-868. Epub 2023 Mar 9 doi: 10.3350/cmh.2022.0434. PMID: 36891607Free PMC Article
Zhou Q, Kang G, Jiang P, Qiao R, Lam WKJ, Yu SCY, Ma ML, Ji L, Cheng SH, Gai W, Peng W, Shang H, Chan RWY, Chan SL, Wong GLH, Hiraki LT, Volpi S, Wong VWS, Wong J, Chiu RWK, Chan KCA, Lo YMD
Proc Natl Acad Sci U S A 2022 Nov;119(44):e2209852119. Epub 2022 Oct 26 doi: 10.1073/pnas.2209852119. PMID: 36288287Free PMC Article
Jiang P, Sun K, Peng W, Cheng SH, Ni M, Yeung PC, Heung MMS, Xie T, Shang H, Zhou Z, Chan RWY, Wong J, Wong VWS, Poon LC, Leung TY, Lam WKJ, Chan JYK, Chan HLY, Chan KCA, Chiu RWK, Lo YMD
Cancer Discov 2020 May;10(5):664-673. Epub 2020 Feb 28 doi: 10.1158/2159-8290.CD-19-0622. PMID: 32111602
Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J
BMJ 2017 Nov 22;359:j5024. doi: 10.1136/bmj.j5024. PMID: 29167102Free PMC Article
Lee NM, Brady CW
World J Gastroenterol 2009 Feb 28;15(8):897-906. doi: 10.3748/wjg.15.897. PMID: 19248187Free PMC Article

Recent systematic reviews

Marasciulo F, Passerini I, Fichera A, Ferrari F, Odicino FE, Prefumo F
Acta Obstet Gynecol Scand 2024 Apr;103(4):653-659. Epub 2023 Aug 2 doi: 10.1111/aogs.14640. PMID: 37533304Free PMC Article
Zhan Y, Xu T, Chen T, Wang X
Acta Obstet Gynecol Scand 2022 Jul;101(7):719-727. Epub 2022 May 22 doi: 10.1111/aogs.14380. PMID: 35599353Free PMC Article
Ovadia C, Seed PT, Sklavounos A, Geenes V, Di Ilio C, Chambers J, Kohari K, Bacq Y, Bozkurt N, Brun-Furrer R, Bull L, Estiú MC, Grymowicz M, Gunaydin B, Hague WM, Haslinger C, Hu Y, Kawakita T, Kebapcilar AG, Kebapcilar L, Kondrackienė J, Koster MPH, Kowalska-Kańka A, Kupčinskas L, Lee RH, Locatelli A, Macias RIR, Marschall HU, Oudijk MA, Raz Y, Rimon E, Shan D, Shao Y, Tribe R, Tripodi V, Yayla Abide C, Yenidede I, Thornton JG, Chappell LC, Williamson C
Lancet 2019 Mar 2;393(10174):899-909. Epub 2019 Feb 14 doi: 10.1016/S0140-6736(18)31877-4. PMID: 30773280Free PMC Article
Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J
BMJ 2017 Nov 22;359:j5024. doi: 10.1136/bmj.j5024. PMID: 29167102Free PMC Article
Leombroni M, Buca D, Celentano C, Liberati M, Bascietto F, Gustapane S, Marrone L, Manzoli L, Rizzo G, D'Antonio F
Ultrasound Obstet Gynecol 2017 Aug;50(2):167-174. Epub 2017 Jul 9 doi: 10.1002/uog.17244. PMID: 27553859

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