Pregnancy

2.  Circulatory changes
 ALP,AFP vs other parameters
 Pro coagulant state
 Compression of IVC small varices

4.  Most common
 Reversible,Recurrence is common
 Pruritus,elevated bile acids and spontaneous relief within 6 weeks of pregnancy
 Complex aetiology
 Incidence usually in third trimester
 Generalized pruritus,elevated bile acids
 Recommended investigation:viral serology,AMA Anti smooth muscle Ab and
USS
 Management:UDCA Rifampicin,SAM,activated charcoal, Cholestyramine,aqueous
cream containing menthol,vitamin k supple

5.  Complication of pre-eclampsia
 Pathogenesis
 Management of preeclampsia

7.  Hepatitis A –similar incidence as non pregnant population
 Hepatitis E –worsened course

8.  Cirrhosis of liver and pregnancy
 Reduced fertility due to disrupted axis
 Increased mortalityvariceal bleeding
 platelet count as an indicator
 Management

9.  HBV DNA levels in mother
 >10_7 copies warrant nucleoside analogue therapy in third trimester which can be
discontinued 1-3 months postpartum
 Universal vaccine prophylaxis
 HBIg plus vaccine
 Tenofovir>lamivudine>telbivudine

10.  Thank you