Hepatosis in pregnant women is a fairly common complication of pregnancy, during which the burden on a woman’s liver increases significantly. Although in the normal course of pregnancy, the liver does not change and completely copes with its functions, bearing a child can become a strong stress for the body and cause the development of various pathological processes. Hepatosis of the liver in pregnant women begins in the third trimester. In this case, due to the increase in viscosity of bile, the deterioration of its outflow, the liver functions worse, ceases to cope with its duties. There is such a complication for a variety of reasons.
- An important role is played by the hereditary, genetic factor: if the family already had hepatosis in the grandmother, in the mother, then, most likely, it will be in the daughter.
- Hepatosis often affects young women who have already had any problems with the liver before pregnancy. It is also very important how well the food is chosen: an excess of fatty, fried, smoked foods in the diet can also lead to illness.
- Often, problems begin because of the intake of vitamin complexes designed specifically for pregnant women, such preparations contain too many substances, they often prescribe high dosages, not taking into account the individual characteristics of the woman, and the body simply cannot cope with their processing.
Due to the fact that hepatosis in pregnant women is increasingly spreading, our forum often has questions about it. They are interested in the symptoms and signs of this disease, how to treat it, etc. We will try to answer all the questions.
Symptoms and signs
In hepatosis of pregnant women, the most characteristic symptoms are:
- itching of the skin (begins with palms, legs and feet, abdomen, gradually spreading throughout the body), scratching the skin,
- worsening or complete loss of appetite, nausea, and sometimes vomiting (not to be confused with toxemia, which ends by the sixteenth week of pregnancy),
- fast fatiguability,
- dull aching pains appear in the right hypochondrium,
- feeling of discomfort in the abdomen,
- sometimes jaundice
- discoloration of feces.
Signs of hepatosis in a pregnant woman can be seen even in the photo of a woman, if you look closely. First, the skin color, which becomes yellowish, can be changed. Secondly, because of problems with the liver, wrinkles may appear on the face, the skin becomes dry, and acne appears on it.
If you notice signs indicating problems with the functional state of the liver, sign up for a consultation with an experienced hepatologist and get tested.
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Diagnosis of the disease
The first problem that occurs during hepatosis in pregnant women is timely and accurate diagnosis. First, many of the signs characteristic of hepatosis in pregnant women are also peculiar to other diseases (nausea and vomiting occur in toxicosis, skin itchiness in allergies and nervous disorders). Secondly, some of the methods of examination of the liver can not be used during pregnancy because of the danger to the fetus (biopsy, laparoscopy, liver scan is prohibited). Thirdly, palpation does not give an accurate result due to the fact that the liver is poorly palpable, and blood biochemistry due to the fact that during pregnancy, many parameters change. Therefore, if any of the signs of hepatosis have already been noticed, it is necessary to immediately refer to a hepatologist: the sooner treatment is started, the more chances for a positive result.
When diagnosing hepatosis, pregnant women should be tested for blood biochemistry (the first sign of illness is an increased concentration of bile acids), ultrasound of the liver and, if necessary, other abdominal organs, the size of the liver in cholestatic hepatosis usually does not change, the liver remains homogeneous, the volume of the gallbladder increases.
Treatment and effects
In order to begin treatment, it is necessary to establish the type and stage of hepatosis in pregnant women. Along with a very common cholestatic, there is such a form as acute fatty hepatosis in pregnant women. Despite all the modern achievements, he still remains a very dangerous disease, threatening death to both mother and child. Therefore, if the disease is diagnosed in the last months of pregnancy, it is necessary to conduct a full examination in order to exclude an acute fatty form in which emergency delivery is used, and then the consequences for mother and baby organisms are eliminated.
When treating you can not use many potent drugs, as they are contraindicated in pregnant women. Therefore, after establishing the form and stage of hepatosis, a decision is made on the period of delivery, and the treatment most often comes down to eliminating the symptoms of the disease as much as possible. Hepatotropic drugs help protect liver cells, vitamins - to eliminate certain syndromes, such as increased fatigue. In some cases, if this is not enough, the disease progresses markedly, plasmapheresis is used, sometimes it is prescribed not one, but several times.
Hepatosis in pregnant women sometimes leads to severe puerperal bleeding, which is dangerous for a woman’s life. That is why, in severe forms of hepatosis, delivery is prescribed at an earlier period (usually at the 38th week).
Despite the discomfort and anxiety that a woman gets hepatosis during pregnancy, the consequences for the child are much more dangerous than for the mother (after birth, all signs of hepatosis in women usually disappear without a trace within one to two weeks, but if you re-pregnancy, hepatosis will most likely return) . Because of it, fetal hypoxia can develop, which later threatens the baby with a lag in development, delayed speech, this is also an indication for emergency delivery.
As with other diseases of the liver, a significant component of treatment for hepatosis in pregnant women is diet. When the disease is mild, it can help completely eliminate the symptoms even without the use of drugs. A very special diet with fatty hepatosis is very important and effective. Proper diet involves 4-5 meals per day, it is desirable that the food was divided into approximately the same portions, you need to eat every day at the same time. In no case can not overeat. It is desirable to use natural products, as extra dyes, flavors and other chemical additives will increase the load. Diet implies a ban on a number of foods and dishes:
- fatty fish and meat,
- salted and canned foods
- smoked meat
- cocoa, coffee, chocolate,
- legumes (peas, lentils, beans),
- fatty dairy products
- fresh bread, pastries and cookies.
Be careful with grapes, lemonades, chilled drinks and ice cream.
It is recommended to eat dried bread (it can be yesterday’s), lean cookies, fresh, baked in the oven or steamed vegetables, more greens, salads from fresh or boiled vegetables and fruits. Meat and fish are recommended to steam or bake. Low-fat cottage cheese and sour cream become an integral part of the diet, various casseroles can be made from the curd. Milk soups and cereals (rice, buckwheat, semolina and oatmeal). Useful jelly and mousse, which diversify the table. Dried fruits and pine nuts are useful for the liver (in small quantities, about a teaspoon per day).
In any diet, a pregnant woman should receive all the necessary vitamins and minerals, so the doctor should make a diet.
What is dangerous hepatosis during pregnancy?
If the disease is not treated, fatty tissue increases in size, and liver cells continue to die. It is not surprising that the neglected form of pathology in pregnant women leads to the development of dangerous, even fatal complications.
Implications for the mother:
- the probability of premature delivery increases,
- bleeding begins after delivery,
- Acute fatty hepatosis in pregnant women leads to death if this type of disease is diagnosed - an artificial termination of pregnancy is shown to save a woman from death.
If you adjust the diet, follow a doctor's prescription, after the postpartum period, the liver condition will return to normal.
Causes of disease
Hepatosis during pregnancy occurs for a number of reasons, but risk factors include:
- Genetic predisposition. If the next of kin was once treated for hepatosis, he will develop with a pregnant woman in the younger generation.
- If, even before pregnancy, the woman had problems with the work of the liver or the presence of chronic liver pathologies.
- Addiction to harmful cholesterol food loads the internal organs.
- Incorrectly chosen vitamin-mineral complex is perhaps the most common cause of the development of pathology. Often taking the means to maintain and fully develop the fetus, a woman puts her body under attack. To avoid this, you need to consult with an obstetrician-gynecologist, who will select the drug and dosage in accordance with the age, weight of the future mother.
- Bad habits.
Symptoms of hepatosis in pregnant women
Since the disease does not appear immediately, it makes it difficult to determine at the very beginning. First, the future mother feels unwell, complains of itchy skin, rashes. However, these symptoms are often referred to as the physiological response of the pregnant woman’s body.
In order to diagnose the disease at the zero or first stage and to be protected from complications, one should listen to one's well-being, and if there are provoking factors, consult a hepatologist.
Over time, the pathology progresses, the fat drops occupying the liver increase and occupy already large foci. The rapid extinction of the body is manifested in the following symptoms:
- Intolerable pruritus, which begins with the limbs, lower abdomen, gradually rising above.
- Loss of interest in food, which is not surprising, because the future mother is worried about constant nausea, vomiting.
- Chronic fatigue.
- Dull "painful" pain in the right hypochondrium.
- Abdominal discomfort.
- Feces become white.
- Urine brown.
- The skin dries out, which leads to the formation of a rash on the body, wrinkles on the face.
Consequences for the fetus
The baby develops serious abnormalities: too little weight, respiratory function disorders. Such violations happen because:
- fetal breathing is hampered by intrauterine nutritional disturbances (hypoxia),
- placental insufficiency develops, due to which the connection between the mother and the child is broken,
- during childbirth the child suffocated.
To avoid the serious consequences of cholestatic hepatosis, you can, if timely engage in the treatment of pathology. If a burn is detected, the child dies.
The key to successful treatment is accurate, timely diagnosis. However, it is very difficult to distinguish the symptoms of the pathology from some features of the future mother's body: nausea and vomiting may be signs of late toxicosis, and a skin rash - just an allergic reaction.
The definition of the diagnosis is complicated by the fact that most effective methods of examination (laparoscopy, biopsy, organ scan) are unacceptable for pregnant women. Blood biochemistry gives distorted indicators due to changes in parameters during pregnancy, and it is not possible to probe the liver. As soon as the first symptoms appear, the woman should apply to the hepatologist herself. The doctor will immediately appoint the following diagnostic measures:
- blood biochemistry, which allows to determine the increased concentration of bile pigments.
- Ultrasound of the liver and, if necessary, other organs of the abdominal cavity. Moreover, in cholestatic hepatosis, the liver is not enlarged, only the gallbladder increases slightly in volume.
After the examination, the doctor can determine the type, stage of the disease. If a burnout is detected, an emergency abortion is recommended.
Treatment and Diet
For the treatment of pregnant women can not use drugs that can harm a child. Therefore, in the cholestatic form of the disease, symptomatic therapy is prescribed, consisting of:
- hepatotropic drugs that save hepatocytes,
- vitamins that relieve fatigue.
If the treatment does not bring the desired effect, plasmapheresis (blood purification) is prescribed.
Since the neglected form of hepatosis causes postpartum hemorrhage that threatens the life of the woman, sometimes the birth is transferred to an earlier date (usually from the 37th week).
Therapeutic value in the case of hepatosis in pregnant women. Properly composed diet helps to cope with 0, 1 degree of pathology. Diet rules:
- Eat fractional, often, at the same time.
- Do not overeat.
- Do not eat hot and cold dishes.
- Exclude products with dyes, flavors and other chemical additives.
- fatty, salty, smoked, fried,
- cocoa, chocolate,
- beans, mushrooms,
- ice cream,
- baked pastries, fresh bread.
- yesterday or dried bread,
- steamed or baked vegetables
- greens, vegetable salads,
- low-fat varieties of fish or meat (boiled or steamed),
- low-fat cottage cheese and sour cream casseroles,
- jelly, mousses,
- milk soups,
- some dried fruit.
To create a balanced menu, you should first consult with a specialist. He will select the necessary vitamin complex.
Prevention and prognosis
With acute fatty hepatosis (burn), the prognosis is very poor - an artificial interruption of pregnancy, in order to save the life of a woman. Cholestatic hepatosis is easily treatable and does not lead to the development of dangerous complications in the mother and child.
To reduce the likelihood of developing the disease during pregnancy, you need:
- Refuse from unhealthy diet, switch to a balanced diet, giving preference to vegetables and fruits.
- Planning a pregnancy, undergo additional examination and complete treatment of existing pathologies.
- To refuse from bad habits.
- Do not self-medicate by prescribing drugs that have a detrimental effect on the liver.
Hepatosis during pregnancy is a danger to the child. Therefore, an appeal to a specialist is necessary at the slightest suspicion of pathology.
Features of hepatosis pregnant
Human liver consists of specific hepatocyte cells, they are responsible for the production of bile acids, which later accumulate in the bile ducts and bladder, are responsible for metabolic processes, processing of all nutrients.
From the intestine, nutrients first appear in the liver. Then processed, spread throughout the body. If there are disturbances in the functioning of hepatocytes, intoxication develops, the body poisons itself. As the pathology worsens, the metabolism and functions of other internal organs change.
There are several types of hepatosis during pregnancy:
- against the background of early toxicosis,
- acute adipose,
- against the backdrop of HELLP syndrome.
Hepatosis in case of early toxicosis is manifested by vomiting, and there are no associated metabolic disturbances.In case of late diagnosis and absence of therapy, the fatty degeneration of hepatocytes is noted.
It is characteristic that early toxicosis hepatosis completely disappears immediately after the termination of pregnancy. If violations of the filtering body are actively progressing, abortion for up to 20 weeks saves a woman's life.
Cholestatic hepatosis in pregnant women is one of the most favorable forms of liver dysfunction. Usually, in cholestatic hepatosis of pregnant women, the symptoms are limited only by slight itching of the skin, yellow tissue.
Acute fatty hepatosis or liver dystrophy is characterized by the transformation of hepatocytes into fat cells, filling with cholesterol, fatty acids. As a result, symptoms of acute liver failure, disorders:
The consequences of acute fatty hepatosis can be the most sad.
Hepatosis of the liver during pregnancy may develop as a result of autoimmune damage to the vascular walls, which inevitably entails various changes in the liver. Clinically, the pathological condition makes itself felt by an increase in the size of the organ, an increase in liver enzymes, which also becomes a threat to the life of the mother and fetus.
Causes, risk group
Hepatosis in pregnant women has various causes and a developmental mechanism. All of them are connected solely by the fact that changes appear only when a child is born and threaten serious health problems.
In addition, hepatosis has a similar clinical picture with hepatitis viral etiology, metabolic diseases, biliary duct dysfunction, cholestasis in cholelithiasis. Only the doctor can determine the final cause of the problem based on the test results.
The exact causes of hepatosis and the mechanism of development have not been established, it is authentically known that the pathology is rare, occurs in one case of 15 thousand pregnancies. Violations susceptible to women with chronic diseases of the biliary system, liver, systemic autoimmune ailments.
At risk patients with:
- increase in liver enzymes of unknown etiology,
- abnormal weight gain during pregnancy.
Hepatosis can develop in primiparous with early preeclampsia, toxicosis. When a lesion joins existing liver diseases, the bile ducts, it is much more complicated. This is due to late diagnosis, chronic liver disease. In this case, the likelihood of death increases.
How to suspect hepatosis?
The difficulty of hepatosis is that it has symptoms similar to those of viral hepatitis. Pathology may be mild, moderate or severe. For this reason, the clinical picture varies from minimal to hepatic coma, systemic intravascular coagulation.
As a rule, the woman first manifestations of the problem appear on the 30-32 week of pregnancy. If liver failure is present in the history of the disease, the situation is aggravated, the symptoms appear earlier.
Among the manifestations of hepatosis:
The most frequent symptom is itching of the skin, the skin of the abdomen, lower, upper limbs is affected. The discomfort can be so unbearable that it worries even at night and does not allow to sleep. In some women, the skin itches slightly, special experiences do not deliver.
With a strong itch, the future mother constantly scratches the skin, damages the tissues, and a secondary infection joins. Itching increasingly begins to appear at any time of the day, which entails regular lack of sleep, a woman becomes whiny, irritable, and hot-tempered.
Hepatosis during pregnancy in 10-15% of cases is manifested by yellowness of the integument. The intensity of the symptom is directly proportional to the severity of the condition of the pregnant. Yellowness is visible only in the albumen of the eye or immediately throughout the body.
- loses appetite, loses weight
- suffers from a constant feeling of nausea, vomiting,
- notes an increase in gas formation,
- notice that the feces become discolored, the urine darkens.
Gradually, weakness, headaches, discomfort in the abdominal cavity, localized in the right hypochondrium. The symptom is aching in nature.
Hepatosis occurs with minimal symptoms, for this reason it is recommended to consult a doctor for diagnosis. The slightest changes in well-being should not be left without close attention.
How can hepatosis affect a child?
With abnormal liver function, the mother suffers and the fetus, hepatosis affects the growth and development of the child. Of all types of pathology, only cholestatic hepatosis gives a minimum of complications. In such situations, there is a chance to carry the baby up to 37 weeks or more. In all other cases, the recommendation of the gynecologist - urgent delivery.
It is important to identify the beginning of the development of hepatosis, it happens that the violation occurs on the background of gestosis, somatic diseases, which greatly complicates the diagnosis. The child is threatened with developmental delay, placental insufficiency, and death in the womb.
First of all, a woman takes a biochemical blood test; in hepatosis, there is an increase in bilirubin, alkaline phosphatase, AST (alanine aminotransferase), ALT (aspartate aminotransferase), and total cholesterol.
In general, the analysis of the blood increases the sedimentation rate of erythrocytes, leukocytes, the fall in red blood cells, hemoglobin.
The coagulogram will show manifestations of decreased blood clotting, formation of prothrombin.
The most informative and safe diagnostic method is an ultrasound examination of the abdominal organs. Especially brightly ultrasound will show fatty dystrophy of hepatocytes. In all other cases, the study will determine the increase in the size of the body, dilated bile ducts.
Ways to remedy the violation
Tactics of treatment depends on the form of pathology. If the doctor makes a diagnosis of acute fatty liver, HELLP syndrome, it is necessary to give birth as soon as possible. Conducted emergency caesarean section, regardless of the period. Therapy provides for the purification of blood, taking medication, diet.
Hemosorption and plasmapheresis are carried out only according to strict indications, procedures will help to get rid of the harmful effects of dangerous toxic substances, pruritus. Together with the liver, the bloodstream is also cleared of metabolic products. The most effective medicines are selected individually.
The essence of the disease
The liver has a complex structure, based on hepatocytes. Due to the many enzymes, the body performs its functions, maintaining the physiological work of the body and the constancy of all its environments. Hepatocytes form bile acids that form bile. In addition, the liver parenchyma is equipped with a multitude of vessels, due to which blood is filtered, which means the conversion of all chemicals. When metabolism fails in hepatocytes, bile-forming, detoxifying and transforming functions of the liver suffer. Result of dysfunction:
- liver failure,
- renal failure
- general intoxication of the body,
- digestive disorders,
- metabolism failures.
This is a serious complication of gestation. The incidence of pathology varies from one to ten cases per 10,000 women in the situation, whereas changes in the results of liver tests are noted in 8% of expectant mothers. Hepatosis of pregnancy is of several types.
Disorders in the liver are observed simultaneously with toxicosis in the early stages. At the same time, there is no obvious clinical picture of the pathology, but it is detected with the help of laboratory tests. Symptoms include nausea and vomiting, swelling, and changes in the composition of urine. The patient's condition is carefully monitored. If the signs of dysfunction increase to 20 weeks, abortion may be recommended.
Pathology provokes improper operation of hepatocytes to convert bile acids. They can accumulate in the ducts, forming bile blood clots. As a result, the components of bile penetrate the bloodstream, spread throughout the body. There is a change in the color of the skin and mucous membranes, there is severe skin itching, especially in the area of the palms. With timely response and proper management of pregnancy, the prognosis is favorable.
Acute hepatic fatty liver begins with the accumulation of fatty acids in hepatocytes. When their level reaches a critical level, the cells are partially or completely replaced by adipose tissue. As a result, hepatic and renal failure occurs, and myocardial function is impaired. This pathology has a negative prognosis. Maternal mortality reaches 30%.
HELLP syndrome - a complex of pathological symptoms:
- appearance of free hemoglobin in urine and serum,
- increased levels of hepatic transferase,
The main problem is hemorrhagic disorders and DIC. As a result, hepatocytes not only cease to function properly, but also die. In the structure of the liver reveal necrotic areas. The proliferation of fibrin fibers is observed in the hepatic vessels. The condition is a threat to the life of the fetus and mother.
The etiology of all types of hepatosis is currently not fully established. Not excluded autoimmune reactions of the body, as well as genetically determined pathology in women. It is noticed that such states tend to repeat within the same family. It is especially necessary to carefully monitor the following pregnant women:
- primiparous with complex forms of early toxicosis,
- primiparous with preeclampsia,
- with impaired liver function tests,
- with chronic ailments of the liver and gall,
- endured acute liver disease before gestation,
- gaining excess weight during gestation.
Depending on the intensity of symptoms, hepatosis is divided into light, moderate and heavy. Signs of abnormalities in the liver may be the following conditions.
- Pruritus This symptom is characteristic of all types of pathology. Most pronounced - with cholestatic liver damage. Localization of unpleasant sensations - the surface of the abdomen, the skin of the palms and feet. Discomfort is worse at night. With intense itching, skin trauma often occurs - scratching, which can serve as a gateway for pathogens. The accession of a secondary infection complicates the treatment of the main disease.
- Jaundiced skin color. Nonspecific symptom of multiple hepatic pathologies. Appears due to the penetration of bile pigments into the bloodstream. Hepatosis accompanies in 15% of cases, mainly its fatty form. Yellowing only the sclera, mucous membranes or the entire skin is called "jaundice." The symptom does not indicate the severity of the disease, it may appear at the very beginning of the pathology or in advanced cases.
- Dyspeptic disorders. Disorders in the liver often manifest themselves nausea, a feeling of heaviness in the abdomen, heartburn. Also observed violations in the bowels - flatulence, constipation or diarrhea. In case of fatty hepatosis, steatorrhea (feces with fat impurities) is noted; in other forms, feces discoloration, change of urine color to darker. In severe vomit and feces may contain blood impurities.
- Pains A characteristic sign of liver damage are pulling, aching or stitching pains in the right hypochondrium. When hepatosis occurs, painful feelings associated with intoxication of the body - headache, abdominal cramps. If kidneys are involved in the pathological process, the patient may be disturbed by pain in the lumbar region.
- General symptoms. Among general changes in well-being, there is rapid fatigue, weakness in muscles, a decrease or a complete lack of appetite. With complicated forms, fever may occur. Persistent itching and fatigue make a pregnant woman emotionally labile, irritable. Sleep disturbances are often noted.
Confirmation of the diagnosis
For the diagnosis prescribed the following studies:
- biochemical blood test,
- urine and feces,
- Reberg test,
- fetal monitoring.
With pathology on ultrasound, visual changes in the structure and color of the liver, deviation from the norm, changes in the size of the gallbladder, and disturbances in the state of the bile ducts are often noted.
The following test results confirm the diagnosis:
- high levels of liver transferase,
- increased bilirubin levels by more than 25%
- reduced hemoglobin level
- K deficiency
- the presence of fatty acids in the urine.
In case of severe damage to the liver in the early stages, abortion may be suggested. If signs of illness develop after 30-32 weeks, an emergency delivery is possible at this time.
Adverse maternal and neonatal prognoses accompany acute fatty liver, as well as HELLP syndrome. With the development of symptoms of pathology, childbirth is carried out on an emergency basis at any time. As a rule, it is a cesarean section. Perhaps natural delivery in readiness of the birth canal. However, such cases are rare.
With a cholestatic form, the prognosis for mother and child is relatively favorable. However, the condition requires drug therapy and careful observation of the patient. Treatment is carried out in the perinatal centers in a stationary mode.
Appointed with early detection of pathology. In future moms, it is preferable to use natural polymeric sorbents (the drug "Polyphepan"). Cleansing the body is carried out for one to two weeks. The sorbent binds excess bile acids in the intestine, preventing dyspeptic disorders and steatorrhea. Assign 10 g twice a day.
When early detection of abnormalities prescribed tablet forms of drugs "Hepabene" or "Hofitol." The course is two to three weeks, during which drugs take one tablet up to three times a day. With complex forms of hepatoprotectors administered intravenously in a mixture with saline. The maximum duration of parenteral therapy is two weeks (with daily administration of drugs).
In parallel, ursodeoxycholic acid, a broad-spectrum hepatoprotector, is prescribed. Available under various trade names. More often -
Ursosan or Ursofalk. Take the medicine two capsules twice in a knock for two to three weeks.
Ademetionin is prescribed in a dose of 400-800 mg intravenously or orally. More often practice intensive parenteral therapy with the subsequent transition to the drug intake.
Vitamin therapy is recommended. Nutrients have an antioxidant effect, normalize metabolic processes in liver tissues:
- Vitamin E - designate 200 IU in the form of capsules orally twice a day.
- ascorbic acid - administered intravenously with glucose solution.
Vascular preparations are prescribed to normalize the state of uteroplacental blood flow. These are Actovegin and Pentoxifylline (intravenous drip).
A pregnant woman should follow a diet until delivery, as well as some time later. Special nutrition can reduce the load on the liver cells, normalize digestion and prevent intoxication of the body. The following rules should be followed:
- exclude - meat broths, offal, mushrooms and legumes, spices and hot sauces,
- limit - refractory fats,
- to give preference to vegetable soups, low-fat sorts of meat and fish, dried yesterday bread, porridges on water,
- cook - steamed and boiled.
In this case, the patient's diet should remain full and balanced. As a source of vitamins, you can cook stews from vegetables, eat fruit and non-acidic fruit juices. It is desirable to completely abandon vegetables containing purine compounds (sorrel, tomatoes), as well as pickles and pickles. A woman should follow similar rules of nutrition even after delivery, even with the complete disappearance of the symptoms of pathology.
Hepatosis may develop slowly, but sometimes there is a rapid flow. In this case, a cesarean section is performed for two days after the diagnosis and intensive preparation of the patient. Neglect of emergency measures is fraught with intrauterine fetal death, the development of cirrhosis in a woman, the death of a mother and child.
With a cholestatic disease, the dangerous effects can be minimized. The prerequisite for this is the early detection of pathology and the carrying out of a full-fledged complex of therapeutic measures.
Severe forms of liver damage entail acute intoxication, dysfunction of the hematoplacental barrier, damage to the vessels of the placenta, up to the formation of hematomas and bleeding. Against the background of such complications, fetal hypoxia and intrauterine growth retardation are observed. Consequences for the child - antenatal death as a result of asphyxia, congenital developmental pathologies, severe disruption of the nervous system. With a favorable course of the disease, successful treatment and the absence of symptoms of fetal hypoxia, pregnancy is prolonged to 38 weeks.
The hepatosis that occurred in a woman during gestation calls into question the possibility of having children in the future - the risk of repeated manifestations of the disease during the next pregnancy is very high.
Hepatosis of the liver: what is it?
Hepatosis of the liver itself is a fatty dystrophy of the organ, manifested by the accumulation of fatty molecules in hepatocytes (liver cells). Today there are 2 known causes of such liver dysfunction: a violation of fat metabolism and excessive intake of fats in the body with food.
Violation of metabolic processes in the body can be triggered by:
- lack of animal protein in the diet,
- excessive consumption of fatty foods
- infectious diseases of the liver,
- alcohol abuse.
The latter, by the way, can be considered the main cause of more frequent cases of this pathology in men than in women. But why does hepatosis occur during pregnancy?
Features of the flow
No matter how strange it may seem, hepatosis is one of the most common liver dysfunctions that occurs in the II-III trimester of pregnancy. Dystrophic changes in the structure of the liver are accompanied by an increase in the viscosity of bile and, as a result, by the difficulty of its outflow and by a general disruption of cellular metabolism. It is believed that pregnancy becomes the main impetus for the development of this pathology in some women.
However, no more than 2% of pregnant women suffer from hepatosis, which means that this is not the only cause of pathology.
As it turned out, most often the causes of hepatosis in women in the situation are rooted in the following factors:
- genetic predisposition - that is, if a mother or grandmother of a pregnant woman suffered from this pathology, it increases the risk of her development in a woman who is expecting a child,
- the presence of liver pathologies in the period before conception - that is, if a woman had problems with the liver before pregnancy,
- irrational use or incorrectly chosen complex of vitamins and minerals is a fairly common cause of hepatosis in women who are zealous with taking vitamin complexes,
- deterioration of fatty acid metabolism due to the violation of the diet or the prevalence of fatty, smoked or fried foods in the diet.
Treatment of hepatosis in pregnant women
So, what is the goal of treating pathology in pregnant women? Obviously, not only the improvement of the future mom's condition, but also the preservation of the normal course of pregnancy to an optimal period. Unfortunately, this pathology often becomes the cause of premature birth, therefore, when making a diagnosis of hepatosis in pregnant women, treatment should be carried out in a hospital setting. The choice of treatment regimen depends on the general condition of the future woman and the severity of the pathology.
|Easy||Use of B vitamins, enterosorbents, hepatoprotectors, antioxidants, diuretics (for edema) and membrane stabilizers|
|Average||The use of folic acid (vitamin B9), stabilizers of the uteroplacental circulation, facilitating itching and detoxification agents|
|Heavy||Detoxification, prevention of bleeding, plasmapheresis|
A prerequisite for the successful treatment of hepatosis in pregnant women is a woman’s compliance with a gentle diet and eating rules:
- fractional meals - in small portions 4-6 times a day,
- food in moderation (do not overeat),
- only healthy food (nothing smoked, fried, canned, fatty and too salty).