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GEBELİKTE KARACİĞER HASTALIKLARI

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Abstract (2. Language): 
Liver disease is rare in pregnancy, occurring in less than 0.1% of pregnancies. Liver disease in pregnancy generally falls into two categories. The first are liver diseases unique to pregnancy consisting of hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, toxemia of pregnancy and HELLP syndrome. The second are liver diseases that occur during pregnancy such as acute viral hepatitis or pregnancy in patients with preexisting liver disease such as chronic hepatitis or liver cirrhosis. When a pregnant woman presents with liver disease, whether the condition is unique to pregnancy must be investigated first. This article briefly examines liver diseases in pregnancy.
Abstract (Original Language): 
Gebelikte karaciğer hastalığı oldukça nadir olup gebeliklerin %0.1’den daha azında görül-mektedir. Gebelikte görülen karaciğer hastalık-ları genellikle iki kategoriye ayrılmaktadır: Bi-rincisi gebelik esnasında ortaya çıkan ve gebe-liğe özgü olan karaciğer hastalıkları olup, bun-lar hiperemezis gravidarum, gebeliğin intrahe-patik kolestazı, gebeliğin akut yağlı karaciğeri, CERRAHPAŞA TIP DERGİSİ Cilt (Sayı) 35 (3) 136 gebelik toksemisi ve HELLP sendromudur. İkincisi ise akut viral hepatit gibi gebelikten bağımsız olarak gebelik esnasında ortaya çıkan yada kronik hepatit ve karaciğer sirozu gibi ge-belikten önce var olan, yani gebeliğe özgü ol-mayan hastalıklarıdır. Bir gebede karaciğer hastalığı saptandığı zaman öncelikle hastalığın gebeliğe özgü olup olmadığı araştırılmalıdır. Bu yazıda gebelikte görülen karaciğer hastalık-ları kısaca irdelenmiştir.
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REFERENCES

References: 

1. Riely CA. Case studies in jaundice of pregnancy. Semin Liver Dis 1988; 8: 191-9
2. Krejs GJ. Jaundice during pregnancy. Semin Liver Dis 1983; 3: 73-82
3. Rolfes DB, Ishak KG. Liver disease in pregnancy. Histopathology 1986; 10: 555-70
4. Riely CA. Hepatic disease in pregnancy. Am J Med 1994; 96: 18S-22S
5. Elliott JR, O'Kell RT. Normal clinical chemical values for pregnant women at term. Clin Chem 1971; 17: 156-7
6. Schorr-Lesnick B, Lebovics E, Dworkin B, Rosenthal WS. Liver diseases unique to pregnancy. Am J Gastroenterol 1991; 86: 659-70
7. Bacq Y, Zarka O, Brechot JF, Mariotte N, Vol S, Tichet J, Weill J. Liver function tests in normal pregnancy: a prospective study of 103 pregnant women and 103 matched controls. Hepatology 1996; 23: 1030-4
8. Sjogren MH. Hepatic emergencies in pregnancy. Med Clin North Am 1993; 77: 1115-27
9. Lunzer M, Barnes P, Byth K, O'Halloran M. Serum bile acid concentrations during pregnancy and their relationship to obstetric cholestasis. Gastroenterology 1986; 91: 825-9
10. Wolf JL. Liver disease in pregnancy. Med Clin North Am 1996; 80: 1167-87
11. Perez V, Gorodisch S, Casavilla F, Maruffo C. Ultrastructure of human liver at the end of normal pregnancy. Am J Obstet Gynecol 1971; 110: 428-31
12. Abell TL, Riely CA. Hyperemesis gravidarum. Gastroenterol Clin North Am 1992; 21: 835-49
13. Singer AJ, Brandt LJ. Pathophysiology of the gastrointestinal tract during pregnancy. Am J Gastroenterol 1991; 86: 1695-1712
14. Goodwin TM, Montoro M, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol 1992; 167: 648-52
15. Riely CA. Liver disease in the pregnant patient. Am J Gastroenterol 1999; 94: 1728-32
16. Nelson-Piercy C, de Swiet M. Corticosteroids for the treatment of hyperemesis gravidarum. Br J Obstet Gynaecol 1994; 101: 1013-15
17. Hsu JJ, Clark-Glena R, Nelson DK, Kim CH. Nasogastric enteral feeding in the management of hyperemesis gravidarum. Obstet Gynecol 1996; 88: 343-6
18. Hallak M, Tsalamandris K, Dombrowski MP, Isada NB, Pryde PG, Evans MI. Hyperemesis gravidarum. Effects on fetal outcome. Reprod Med 1996; 41: 871-4
19. Kallen B. Hyperemesis during pregnancy and delivery outcome: a registry study. Eur J Obstet Gynecol Reprod Biol 1987; 26: 291-302
20. Gross S, Librach C, Cecutti A. Maternal weight loss associated with hyperemesis gravidarum: a predictor of fetal outcome. Am J Obstet Gynecol 1989; 160: 906-9
21. Reyes H, Simon FR. Intrahepatic cholestasis of pregnancy: an estrogen-related disease. Semin Liver Dis 1993; 13: 289-301
22. Reyes H. The enigma of intrahepatic cholestasis of pregnancy: lessons from Chile. Hepatology 1982; 2: 87-96
23. Vore M. Estrogen cholestasis. Membranes, metabolites, or receptors? Gastroenterology 1987; 93: 643-9
24. Holzbach RT, Sivak DA, Braun WE. Familial recurrent intrahepatic cholestasis of pregnancy: a genetic study providing evidence for transmission of a sex-limited, dominant trait. Gastroenterology 1983; 85: 175-9
25. Reyes H, Wegmann ME, Segovia N, Cuchacovich M, Jadresic E, Contador M, Fuentes C, et al. HLA in Chileans with intrahepatic0 cholestasis of pregnancy. Hepatology 1982; 2: 463-6
26. Olsson R, Tysk C, Aldenborg F, Holm B. Prolonged postpartum course of intrahepatic cholestasis of pregnancy. Gastroenterology 1993; 105: 267-71
27. Lunzer M, Barnes P, Byth K, O'Halloran M. Serum bile acid concentrations during pregnancy and their relationship to obstetric cholestasis. Gastroenterology 1986; 91: 825-9
28. Heikkinen J. Serum bile acids in the early diagnosis of intrahepatic cholestasis of pregnancy. Obstet Gynecol 1983; 61: 581-7
29. Wilson JA. Intrahepatic cholestasis of pregnancy with marked elevation of transaminases in a black American. Dig Dis Sci 1987; 32: 665-8
30. Reyes H, Radrigan ME, Gonzalez MC, Latorre R, Ribalta J, Segovia N, Alvarez C, et al. Steatorrhea in patients with intrahepatic cholestasis of pregnancy. Gastroenterology 1987; 93: 584-90
31. Rioseco AJ, Ivankovic MB, Manzur A, Hamed F, Kato
Temmuz-Eylül 2004 GEBELİKTE KARACİĞER HASTALIKLARI; ÖZDEMİR VE AKIN
137
SR, Parer JT, Germain AM. Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome. Am J Obstet Gynecol 1994; 170: 890-5
32. Davies MH, da Silva RC, Jones SR, Weaver JB, Elias E. Fetal mortality associated with cholestasis of pregnancy and the potential benefit of therapy with ursodeoxycholic acid. Gut 1995; 37: 580-4
33. Palma J, Reyes H, Ribalta J, Iglesias J, Gonzalez MC, Hernandez I, Alvarez C, et al. Effects of ursodeoxycholic acid in patients with intrahepatic cholestasis of pregnancy. Hepatology 1992; 15: 1043-7
34. Alsulyman OM, Ouzounian JG, Ames-Castro M, Goodwin TM. Intrahepatic cholestasis of pregnancy: perinatal outcome associated with expectant management. Am J Obstet Gynecol 1996; 175: 957-60
35. Matos A, Bernardes J, Ayres-de-Campos D, Patricio B. Antepartum fetal cerebral hemorrhage not predicted by current surveillance methods in cholestasis of pregnancy. Obstet Gynecol 1997; 89: 803-4
36. Hirvioja ML, Kivinen S. Inheritance of intrahepatic cholestasis of pregnancy in one kindred. Clin Genet 1993; 43: 315-7
37. Kaplan MM. Acute fatty liver of pregnancy. N Engl J Med 1985; 313: 367-70
38. Rolfes DB, Ishak KG. Acute fatty liver of pregnancy: a clinicopathologic study of 35 cases. Hepatology 1985; 5: 1149-58
39. Pockros PJ, Peters RL, Reynolds TB. Idiopathic fatty liver of pregnancy: findings in ten cases. Medicine 1984; 63: 1-11
40. Reyes H, Sandoval L, Wainstein A, Ribalta J, Donoso S, Smok G, Rosenberg H, et al. Acute fatty liver of pregnancy: a clinical study of 12 episodes in 11 patients. Gut 1994; 35: 101-6
41. Riely CA, Latham PS, Romero R, Duffy TP. Acute fatty liver of pregnancy. A reassessment based on observations in nine patients. Ann Intern Med 1987; 106: 703-6
42. Burroughs AK, Seong NH, Dojcinov DM, Scheuer PJ, Sherlock SV. Idiopathic acute fatty liver of pregnancy in 12 patients. Q J Med 1982; 51: 481-97
43. Riely CA. Acute fatty liver of pregnancy. Semin Liver Dis 1987; 7: 47-54
44. Wilcken B, Leung KC, Hammond J, Kamath R, Leonard JV. Pregnancy and fetal long-chain 3-hydroxyacyl coenzyme A dehydrogenase deficiency. Lancet 1993; 341: 407-8
45. Treem WR, Shoup ME, Hale DE, Bennett MJ, Rinaldo P, Millington DS, Stanley CA, et al. Acute fatty liver of pregnancy, hemolysis, elevated liver enzymes, and low platelets syndrome, and long chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency. Am J Gastroenterol 1996; 91: 2293-300
46. Mansouri A, Fromenty B, Durand F, Degott C, Bernuau J, Pessayre D. Assessment of the prevalence of genetic metabolic defects in acute fatty liver of pregnancy. J Hepatol 1996; 25: 781
47. Sims HF, Brackett JC, Powell CK, Treem WR, Hale DE, Bennett MJ, Gibson B, et al. The molecular basis of pediatric long chain 3-hydroxyacyl-CoA dehydrogenase deficiency associated with maternal acute fatty liver of pregnancy. Proc Natl Acad Sci USA 1995; 92: 841-5
48. Schoeman MN, Batey RG, Wilcken B. Recurrent acute fatty liver of pregnancy associated with a fatty-acid oxidation defect in the offspring. Gastroenterology 1991; 100: 544-8
49. Vanjak D, Moreau R, Roche-Sicot J, Soulier A, Sicot C. Intrahepatic cholestasis of pregnancy and acute fatty liver of pregnancy. An unusual but favorable association? Gastroenterology 1991; 100: 1123-5
50. Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am J Obstet Gynecol 1982;142: 159-67
51. Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets. Am J Obstet Gynecol 1993; 169: 1000-6
52. Sullivan CA, Magann EF, Perry KG Jr, Roberts WE, Blake PG, Martin JN Jr. The recurrence risk of the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) in subsequent gestations. Am J Obstet Gynecol 1994; 171: 940-3
53. Barton JR, Riely CA, Adamec TA, Shanklin DR, Khoury AD, Sibai BM. Hepatic histopathologic condition does not correlate with laboratory abnormalities in HELLP syndrome. Am J Obstet Gynecol 1992; 167: 1538-43
54. Krueger KJ, Hoffman BJ, Lee WM. Hepatic infarction associated with eclampsia. Am J Gastroenterol 1990; 85: 588-92
55. Greenstein D, Henderson JM, Boyer TD. Liver hemorrhage: recurrent episodes during pregnancy complicated by preeclampsia. Gastroenterology 1994; 106: 1668-71
56. Alexander J, Cuellar RE, Van Thiel DH.Toxemia of pregnancy and the liver. Semin Liver Dis 1987; 7: 55-8
57. Barron WM. The syndrome of preeclampsia. Gastroenterol Clin North Am 1992; 21: 851-72
58. Seligman SP, Buyon JP, Clancy RM, Young BK, Abramson SB. The role of nitric oxide in the pathogenesis of preeclampsia. Am J Obstet Gynecol 1994; 171: 944-8
59. Rolfes DB, Ishak KG. Liver disease in toxemia of pregnancy. Am J Gastroenterol 1986; 81: 1138-44
60. Manas KJ, Welsh JD, Rankin RA, Miller DD. Hepatic
CERRAHPAŞA TIP DERGİSİ Cilt (Sayı) 35 (3)
138
hemorrhage without rupture in preeclampsia. N Engl J Med 1985; 312: 424-26
61. Cheung H, Hamzah H. Liver rupture in pregnancy: a typical case? Singapore Med J 1992; 33: 89-91
62. Minuk GY, Lui RC, Kelly JK. Rupture of the liver associated with acute fatty liver of pregnancy.Am J Gastroenterol 1987; 82: 457-60
63. Loevinger EH, Vujic I, Lee WM, Anderson MC. Hepatic rupture associated with pregnancy: treatment with transcatheter embolotherapy. Obstet Gynecol 1985; 65: 281-4
64. Barton JR, Sibai BM. Care of the pregnancy complicated by HELLP syndrome. Gastroenterol Clin North Am 1992; 21: 937-50
65. Greenstein D, Henderson JM, Boyer TD. Liver hemorrhage: recurrent episodes during pregnancy complicated by preeclampsia. Gastroenterology 1994; 106: 1668-71
66. Tiliacos M, Tsantoulas D, Tsoulias A, Kokka E, Eudaimon E, Aphentoglou S, Metzantonakis C. The Budd-Chiari syndrome in pregnancy. Postgrad Med J 1978; 54: 686-91
67. Gatell Artigas JM, Sala Estabanez J, Aused Faure MR. Pregnancy and the Budd-Chiari syndrome. Dig Dis Sci 1982; 27: 89-90
68. Khuroo MS, Datta DV. Budd-Chiari syndrome following pregnancy. Report of 16 cases, with roentgenologic, hemodynamic and histologic studies of the hepatic outflow tract. Am J Med 1980; 68: 113-21
69. Rosenthal T, Shani M, Deutsch V, Samra H. The Budd-Chiari syndrome after pregnancy. Report of two cases and a review of the literature. Am J Obstet Gynecol 1972; 113: 789-92
70. Maddrey WC. Hepatic vein thrombosis (Budd Chiari syndrome): possible association with the use of oral contraceptives. Semin Liver Dis 1987;7: 32-9
71. Simms J, Duff P. Viral hepatitis in pregnancy. Semin Perinatol 1993; 17: 384-93
72. ACOG Technical Bulletin Number 174--November 1992. Hepatitis in pregnancy. Int J Gynaecol Obstet 1993; 42: 189-98
73. Watson JC, Fleming DW, Borella AJ, Olcott ES, Conrad RE, Baron RC. Vertical transmission of hepatitis A resulting in an outbreak in a neonatal intensive care unit. J Infect Dis 1993; 167: 567-71
74. Mishra L, Seeff LB. Viral hepatitis, A though E, complicating pregnancy. Gastroenterol Clin North Am 1992; 21: 873-87
75. Pastorek JG 2d. The ABCs of hepatitis in pregnancy. Clin Obstet Gynecol 1993; 36: 843-54
76. Program to prevent perinatal hepatitis B virus transmission in a health-maintenance organization--Northern California, 1990-1995. Morb Mortal Wkly Rep 1997; 46: 378-80
77. Hollinger FB. Comprehensive control (or elimination) of hepatitis B virus transmission in the United States. Gut 1996; 38(Suppl 2): S24-S30
78. Leads from the MMWR. Prevention of perinatal transmission of hepatitis B virus: prenatal screening of all pregnant women for hepatitis B surface antigen. JAMA 1988; 260: 165-70
79. Zanetti AR, Ferroni P, Magliano EM, Pirovano P, Lavarini C, Massaro AL, Gavinelli R, et al. Perinatal transmission of the hepatitis B virus and of the HBV-associated delta agent from mothers to offspring in northern Italy. J Med Virol 1982; 9: 139-48
80. Ohto H, Terazawa S, Sasaki N, Sasaki N, Hino K, Ishiwata C, Kako M, et al. Transmission of hepatitis C virus from mothers to infants. The Vertical Transmission of Hepatitis C Virus Collaborative Study Group. N Engl J Med 1994; 330: 744-50
81. Lin HH, Kao JH, Hsu HY, Ni YH, Chang MH, Huang SC, Hwang LH, et al. Absence of infection in breast-fed infants born to hepatitis C virus-infected mothers. Pediatr 1995; 126: 589-91
82. Khuroo MS, Kamili S, Jameel S. Vertical transmission of hepatitis E virus. Lancet 1995; 345: 1025-6
83. Klein NA, Mabie WC, Shaver DC, Latham PS, Adamec TA, Pinstein ML, Riely CA. Herpes simplex virus hepatitis in pregnancy. Two patients successfully treated with acyclovir. Gastroenterology 1991; 100: 239-44
84. Jacques SM, Qureshi F. Herpes simplex virus hepatitis in pregnancy: a clinicopathologic study of three cases. Hum Pathol 1992; 23: 183-7
85. Makkonen M, Huttunen M, Martikainen A, Saarikoski S. Cytomegalovirus hepatitis in late pregnancy. Int J Gynaecol Obstet 1992; 37: 199-201
86. Finegold MJ, Carpenter RJ. Obliterative cholangitis due to cytomegalovirus: a possible precursor of paucity of intrahepatic bile ducts. Hum Pathol 1982; 13: 662-5
87. Chang MH, Huang HH, Huang ES, Kao CL, Hsu HY, Lee CY. Polymerase chain reaction to detect human cytomegalovirus in livers of infants with neonatal hepatitis. Gastroenterology 1992; 103: 1022-5
88. Schreyer P, Caspi E, El-Hindi JM, Eshchar J. Cirrhosis--pregnancy and delivery: a review. Obstet Gynecol Surv 1982; 37: 304-12
89. Britton RC. Pregnancy and esophageal varices. Am J Surg 1982; 143: 421-5
90. Homburg R, Bayer I, Lurie B. Bleeding esophageal varices in pregnancy. A report of two cases. Reprod Med 1988; 33: 784-6
Temmuz-Eylül 2004 GEBELİKTE KARACİĞER HASTALIKLARI; ÖZDEMİR VE AKIN
139
91. Iwase H, Morise K, Kawase T, Horiuchi Y. Endoscopic injection sclerotherapy for esophageal varices during pregnancy. J Clin Gastroenterol 1994; 18: 80-3
92. Augustine P, Joseph PC. Sclerotherapy for esophageal varices and pregnancy. Gastrointest Endosc 1989; 35: 467-8
93. Salena BJ, Sivak MV Jr. Pregnancy and esophageal varices. Gastrointest Endosc 1988; 34: 492-3
94. Cheng YS. Pregnancy in liver cirrhosis and/or portal hypertension. Am J Obstet Gynecol 1977; 128: 812-22
95. Lee WM. Pregnancy in patients with chronic liver disease. Gastroenterol Clin North Am 1992; 21: 889-903
96. Steven MM. Pregnancy and liver disease. Gut 1981; 22: 592-614
97. Walshe JM. The management of pregnancy in Wilson's disease treated with trientine. Q J Med 1986; 58: 81-7
98. Lee MG, Hanchard B, Donaldson EK, Charles C, Hall JS. Pregnancy in chronic active hepatitis with cirrhosis. J Trop Med Hyg 1987; 90: 245-8
99. Steven MM, Buckley JD, Mackay IR. Pregnancy in chronic active hepatitis. Q J Med 1979; 48: 519-31.
100. Walshe JM. Pregnancy in Wilson's disease. Q J Med 1977; 46: 73-83
101. Maringhini A, Marceno MP, Lanzarone F, Caltagirone M, Fusco G, Di Cuonzo G, Cittadini E, Pagliaro L. Sludge and stones in gallbladder after pregnancy. Prevalence and risk factors. J Hepatol 1987; 5: 218-23
102. Tsimoyiannis EC, Antoniou NC, Tsaboulas C, Papanikolaou N. Cholelithiasis during pregnancy and lactation. Prospective study. Eur J Surg 1994; 160: 627-631
103. Everson GT, McKinley C, Lawson M, Johnson M, Kern F Jr. Gallbladder function in the human female: effect of the ovulatory cycle, pregnancy, and contraceptive steroids. Gastroenterology 1982; 82: 711-9
104. Jamidar PA, Beck GJ, Hoffman BJ, Lehman GA, Hawes RH, Agrawal RM, Ashok PS, et al. Endoscopic retrograde cholangiopancreatography in pregnancy. Am J Gastroenterol 1995; 90: 1263-7
105. Baillie J, Cairns SR, Putman WS, Cotton PB. Endoscopic management of choledocholithiasis during pregnancy. Surg Gynecol Obstet 1990; 171: 1-4
106. Swisher SG, Schmit PJ, Hunt KK, Hiyama DT, Bennion RS, Swisher EM, Thompson JE. Biliary disease during pregnancy. Am J Surg 1994; 168: 576-81
107. Morrell DG, Mullins JR, Harrison PB. Laparoscopic cholecystectomy during pregnancy in symptomatic patients. Surgery 1992; 112: 856-9
108. Sherlock S, Dooley J. Diseases of the Liver and Biliary System. 10th ed. Oxford, Blackwell Scientific Publications, 1997; 475-83
109. Radomski JS, Moritz MJ, Munoz SJ, Cater JR, Jarrell BE, Armenti VT. National Transplantation Pregnancy Registry: analysis of pregnancy outcomes in female liver transplant recipients. Liver Transpl Surg 1995; 1: 281-4
110. Ramsey PS, Hay JE, Ramin KD. Successful pregnancy following orthotopic liver transplantation for idiopathic Budd-Chiari syndrome. J Matern Fetal Med 1998; 7: 235-237.

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