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Maternal hepatobiliary conditions 

Maternal hepatobiliary conditions
Maternal hepatobiliary conditions

Harini Narayan

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date: 14 June 2021

This chapter includes some conditions relatively common in pregnancy, such as obstetric cholestasis and gallstones, as well as rarer conditions including pancreatitis, Wilson’s disease, Gilbert’s syndrome, acute intermittent porphyria, autoimmune hepatitis, and haemochromatosis. Relevant pre-pregnancy counselling is highlighted as well as the epidemiology, aetiology, symptoms, differential diagnosis, diagnostic tests, imaging, potential impact on pregnancy outcomes, fetal monitoring, and management strategies. Enzymatic/genetic defects, altered pharmacokinetics, drugs or supplements to avoid, and serial monitoring of abnormal liver function tests are summarized. Multidisciplinary management, including immediate treatment, pharmacological options and dietary alterations are incorporated in the fact files and care pathways for each condition. Appropriate timing of delivery and avoidance of unnecessary interventions are highlighted. Care pathways are based on national/international guidelines and good practice recommendations. Clear management plans for antenatal care, labour, and delivery including anaesthetic aspects, postnatal surveillance and appropriate contraception are presented, along with patient information for each condition.

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