Anesthetic considerations for liver diseases unique to pregnancy

doi:10.5313/wja.v5.i3.54

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World Journal of Anesthesiology

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2218-6182

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World J Anesthesiol. Nov 27, 2016; 5(3): 54-61
Published online Nov 27, 2016. doi: 10.5313/wja.v5.i3.54

Anesthetic considerations for liver diseases unique to pregnancy

Berrin Gunaydin, Ayca Tas Tuna

Berrin Gunaydin, Department of Anesthesiology, Gazi University School of Medicine, 06500 Ankara, Turkey

Ayca Tas Tuna, Department of Anesthesiology, Sakarya University School of Medicine, 54100 Sakarya, Turkey

Author contributions: Both authors contributed to this manuscript.

Conflict-of-interest statement: We, the authors, declare and sign that we do not have any conflict of interest.

Correspondence to: Berrin Gunaydin, MD, PhD, Professor of Anesthesia, Department of Anesthesiology, Gazi University School of Medicine, Besevler, 06500 Ankara, Turkey. gunaydin@gazi.edu.tr

Telephone: +90-312-2025318

Received: April 27, 2016
Peer-review started: April 28, 2016
First decision: June 16, 2016
Revised: July 13, 2016
Accepted: July 29, 2016
Article in press: August 1, 2016
Published online: November 27, 2016
Processing time: 204 Days and 21.1 Hours

Abstract

Liver diseases that are most unique to pregnancy consist of hyperemesis gravidarum, acute fatty liver of pregnancy, intrahepatic cholestasis of pregnancy, and hemolysis, elevated liver enzymes and low platelets syndrome. In this review, risk factors, etiology, symptoms, diagnosis, prognosis and treatment of each entity followed by principles of anesthetic management based on the case reports or retrospective records will be addressed.

Keywords: Liver disease; Pregnancy; Anesthesia

Core tip: Liver diseases like hyperemesis gravidarum, acute fatty liver of pregnancy, intrahepatic cholestasis of pregnancy and hemolysis, elevated liver enzymes and low platelets are challenging for anesthesiologists because of the increased risk of morbidity and mortality. Therefore, general and specific anesthetic management strategies are of utmost important. In this review, the risk factors, etiology, symptoms, diagnosis, prognosis and treatment of these liver diseases during pregnancy and general principles of anesthetic management based on our case report and retrospective records will be addressed.