Acute hepatic dysfunction and pregnancy

Ya.M. Pidhirny


The lecture deals with the causes of acute hepatic dysfunction in pregnant women. It discusses the pathogenesis and morphologic changes of different organs in pregnant women suffering from preeclampsia/eclampsia with the signs of acute hepatic dysfunction. Thrombotic microangiopathy which complicates the course of pregnancy is characterized by the damage of microvascular blood stream in different organs, thrombocytopenia and hemolytic anemia. The pregnancy is known as one of the main triggers for thrombotic microangio­pathy development. On one hand, pregnancy stimulates an increase in the level of von Willebrand factor (vWF) that can be caused by the action of estrogens. On the other hand, pregnancy is characterized by the decrease of ADAVNS 13 enzyme activity that may be caused by its increased consumption. The main role of this enzyme is to destroy vWF multimers. The physiological purpose of vWF is to provide the platelet adhesion to the subendothelial matrix in case of vascular damage and hemodynamic stress. The peculiarities of the development of the acute adipose hepatic dystrophy, HELLP syndrome and cholestatic hepatosis have been described.The main features of clinical evidence and intensive care of pregnant women with various forms of hepatic dysfunctions have been shown.


pregnancy; preeclampsia; acute adipose hepatic dystrophy; HELLP syndrome; cholestatic hepatosis


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