Liver and Biliary Disease of Pregnancy and Anesthetic Implications: A Review

Anesth Analg. 2021 Jul 1;133(1):80-92. doi: 10.1213/ANE.0000000000005433.

Abstract

Liver and biliary disease complicates pregnancy in varying degrees of severity to the mother and fetus, and anesthesiologists may be asked to assist in caring for these patients before, during, and after birth of the fetus. Therefore, it is important to be familiar with how different liver diseases impact the pregnancy state. In addition, knowing symptoms, signs, and laboratory markers in the context of a pregnant patient will lead to faster diagnosis and treatment of such patients. This review article discusses changes in physiology of parturients, patients with liver disease, and parturients with liver disease. Next, general treatment of parturients with acute and chronic liver dysfunction is presented. The article progresses to specific liver diseases with treatments as they relate to pregnancy. And finally, important aspects to consider when anesthetizing parturients with liver disease are discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anesthesia, Obstetrical / methods*
  • Anesthesia, Obstetrical / standards
  • Bile Duct Diseases / epidemiology
  • Bile Duct Diseases / therapy*
  • Female
  • Humans
  • Liver Diseases / epidemiology
  • Liver Diseases / therapy*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / therapy*
  • Prenatal Care / methods*
  • Prenatal Care / standards