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Abstract
The liver is one of the many organs affected by the physiologic and hormonal changes that occur during pregnancy. Some of the normal physiologic changes of pregnancy can mimic abnormalities associated with liver diseases. In an uncomplicated pregnancy, many laboratory test-results may appear abnormal according to standards derived from a non pregnant population, For example, serum albumin concentration decrease from a mean of 4.2 g per deciliter in non pregnant women to 3.1 g per deciliter near the end of gestation because of an increase in plasma volume, and serum alkaline phosphatase concentrations rise above the normal range for non pregnant woman during the fifth month of pregnancy and continue to rise to values two to four times normal by the end of gestation because of the leakage of placental alkaline phosphatase into the maternal blood. However, values for serum aminotransferases and bilirubin are normally unchanged. Thus, any increase in these values may reflect hepatobiliary pathology. Liver disorders that are specific to pregnancy, including hyperemesis gravidarum, intrahepatic cholestasis of pregnancy pre-eclampsia/eclampsia, HELLP syndrome, and hepatic rupture, may have a profound impact on the morbidity and mortality rates of mother and fetus. Diseases such as acute fatty liver of pregnancy may begin with mild symptoms and liver-enzyme abnormalities but, if left untreated, can progress to jaundice, liver failure, and death.