ABSTRACT
Liver diseases in pregnancy include: those present at conception; those that occur coincidentally; and those that occur as a result of pregnancy. If liver disease is suspected, the most important factor is to determine the gestational age of the pregnancy, as the differential diagnoses change with the stage of the pregnancy. A history of intravenous drug use or alcohol abuse will make certain forms of liver disease much more likely. Abdominal pain, particularly in late pregnancy, may be extremely important as it can be a sign of acute fatty liver, hepatic rupture, or eclampsia, or rather less worrying but more common, gallstones. Jaundice is rare during pregnancy, and has no prognostic importance in terms of the severity of the liver disease. In liver failure, a change in the international normalised ratio or prothrombin time is the most sensitive and rapid indicator of liver synthetic function, and hence liver failure.
