MEDIX, God. 24 Br. 132 Supplement 1  •  Pregledni članak  •  Gastroenterologija HR ENG

Bolesti jetre povezane s trudnoćomPregnancy-related liver diseases

Ivana Mikolašević, Lucija Virović Jukić, Ivica Grgurević, Tajana Filipec Kanižaj, Tomislav Bokun, Margareta Ugljarević, Tajana Stevanović, Sandra Milić

Bolesti jetre koje su povezane s trudnoćom karakteristično se pojavljuju u pojedinim trimestrima, dok se bolesti jetre koje nisu izravno povezane s trudnoćom mogu pojaviti u bilo kojemu trenutku. Razdoblje pojavljivanja kliničkih manifestacija i abnormalnih rezultata testova jetrene funkcije bitno je u postavljanju dijagnoze i strategije liječenja. Intrahepatična kolestaza u trudnoći (engl. intrahepatic cholestasis of pregnancy, ICP), akutna masna jetra u trudnoći (engl. acute fatty liver of pregnancy, AFLP) i sindrom HELLP (engl. hemolysis, elevated liver enzymes and low platelets, HELLP) karakteristično se pojavljuju u trećemu trimestru trudnoće. U liječenju AFLP-a i HELLP-a prijeko je potreban brz dovršetak trudnoće te stabilizacija majčina kliničkoga stanja, što najčešće zahtijeva liječenje u jedinicama intenzivnoga liječenja. Krajnja metoda liječenja AFLP-a i sindroma HELLP jest transplantacija jetre.

Ključne riječi:
intrahepatična kolestaza; akutna masna jetra u trudnoći; HELLP-sindrom

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 24 Br. 132 Supplement 1

Liver diseases associated with pregnancy typically occur in particular pregnancy trimesters, while liver diseases not directly related to pregnancy may occur at any given time. The period of onset of clinical manifestations and abnormal liver function tests results is essential in setting the diagnosis and the treatment strategy. Intrahepatic cholestasis of pregnancy (ICP), acute fat liver in pregnancy (AFLP) and HELLP syndrome (elevated liver enzymes and low platelets, HELLP) typically occur in the third trimester of pregnancy. Regarding the treatment of AFLP and HELLP, it is essential to urgently deliver the baby and stabilize the mother's clinical condition, which most often requires treatment in intensive care units. The last method of choice of treating AFLP and HELLP syndrome is liver transplantation. 

Key words:
acute fat liver in pregnancy; HELLP syndrome; intrahepatic cholestasis