Liver failure during pregnancy

C E Eapen¹, B Ramakrishna², R Jose³, G Loganathan¹, G Chandy¹

¹ Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
² Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India
³ Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence to:
Dr C E Eapen, Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India, 632004; eapen{at}cmcvellore.ac.in

This is an introduction to the Gut tutorial "Liver failure during pregnancy" hosted on BMJ Learning—the best available learning website for medical professionals from the BMJ Group.

This module discusses the clinical management of acute liver failure occurring in pregnancy. Early recognition of possible causes and prompt treatment are crucial for successful outcome. Differentiating pregnancy-related liver dysfunction from liver dysfunction due to causes unrelated to pregnancy is often not possible clinically. Clinical criteria, used to diagnose the cause of liver dysfunction antenatally, often overlap. Clinical decision making in this setting has to be carried out within the constraints of not being able to make a precise diagnosis antenatally. If acute liver failure due to a pregnancy-related cause (such as acute fatty liver of pregnancy) is a possible differential diagnosis, urgent delivery of the baby is warranted. The association of inherited fatty acid oxidation disorders and maternal liver disease is being increasingly recognised. However, the exact mechanism of this foetal–maternal interaction is not yet known. Awareness of this association is important in providing counselling about the risk of maternal liver disease in subsequent pregnancies and deciding need for any specific therapy in the baby.

To access the tutorial (Interactive Case History), click on BMJ Learning: take this module on BMJ Learning from the content box at the top right and bottom left of the online article. For more information please go to: http://gut.bmj.com/tutorials/collection.dtl

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Competing interests: None.

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