Problematics of liver pathology during gestation

Ensuring the gestation of a full-fledged fetus and maintaining the health of a pregnant woman is the most important task throughout gestation. Diseases of the gastrointestinal tract in the gestational period cause difficulties in diagnosis. In order to evaluate modern clinical recommendations in the field of diagnosis and safe correction of liver pathology during pregnancy, a collection of modern domestic and foreign literature sources on liver diseases during pregnancy, generalization and critical analysis of this problem was carried out. The article describes problems with the liver and biliary tract that can occur at different stages of pregnancy and complicate its course. The main attention is paid to pregnancy-related conditions, including excessive vomiting of pregnant women, intrahepatic cholestasis of pregnant women, acute fatty liver dystrophy of pregnant women. The article clarifies at what gestation periods the above problems may occur. The text provides biochemical markers that are recommended for the above conditions, highlights the biochemical mechanisms that lead to them. In addition, it should be borne in mind that a number of liver diseases, for example primary biliary cirrhosis of the liver, may first appear during pregnancy, therefore, for the purpose of differential diagnosis with intrahepatic cholestasis of pregnant women, the determination of antimitochondrial antibodies, antibodies to smooth muscle fibers is required, which facilitates the diagnosis of serious autoimmune liver pathology. Special attention is paid to such a life-threatening condition as acute fatty liver dystrophy of pregnant women. A detailed analysis of both the clinical picture and laboratory parameters makes it possible to resolve the issue of further prolongation of pregnancy and treatment, or immediate delivery. In certain situations, this is the only right solution to save the mother and fetus.