N Tsonev, D Notev, I Kostov, E Ivanova, K Toncheva
The focus of this article is on the most important (prognostic and therapeutic) pregnancy related liver diseases: cholestasis of pregnancy, preeclampsia induced liver disfunction and intrahepatic cholestasis of pregnancy, eclampsia (including HELLP – hemolisys, elevated liver enzymes, low platelet count) and acute hepatic steatosis. They are completely reversible after delivery and must be distinguished from other intercurrent liver diseases, for which pregnancy is a possible precipitating factor.Intrahepatic (obstetric) cholestasis of pregnancy (ICP) is a unique hepatobiliary condition that manifests itself with itching, jaundice, an increase in the serum concentration of bile acids and poses a risk of complications for both the mother and the baby. ICP is a reversible type of hormonally influenced cholestasis. It develops during the third trimester, when hormone concentrations are at their peak. Ursodeoxycholic acid relieves pruritus and improves liver function tests in pregnant women in intrahepatic cholestasis and largely reduces fetal mortality, but has a secondary role in HELLP syndrome and acute hepatic steatosis during pregnancy, where timely delivery is the key to treatment.