[Abnormal liver function tests in pregnancy: a single institution experience].
OBJECTIVE
Elevated transaminase levels are often detected during pregnancy. Causes are variable and difficult to differentiate. Furthermore, there is no practical guideline for abnormal transaminase levels in pregnancy. The aim of this study was to suggest a strategy for managing elevated transaminase level during pregnancy.


METHODS
One hundred and fifty-five women with elevated transaminase level were included from an antenatal care center between January 1, 2003 and December 31, 2004. Another 221 women with normal transaminase levels were enrolled as control group. We analyzed documented causes, changes in laboratory tests, and pregnancy outcomes.


RESULTS
Two groups showed no difference in baseline characteristics except the duration of pregnancy, parity, and albumin level. Of abnormal results, 39.4% occurred between 30 and 40 gestational weeks while 29% occurred between 10 and 20 gestational weeks. Common causes were hyperemesis gravidarum followed by pre-eclampsia, viral hepatitis, and HELLP syndrome. Excluding viral hepatitis, 69 patients showed abnormal results in the first two trimesters and the results were normalized during the follow-up period. AST and ALT levels were 52.9 (+/-49.6) IU/L and 83.3 (+/-77.0) IU/L during the first two trimesters in the patient group. Abnormal results during the third trimester were associated with shorter duration of pregnancy.


CONCLUSIONS
Elevated transaminase levels up to 3 to 4 times of the upper normal limit during the first two trimesters could be safely observed with careful history taking and hepatitis viral antigen tests. However, abnormal results in the third trimester were associated with a shorter duration of pregnancy and should be managed carefully.
Kim
Jung Hyun
JH
Departments of Internal Medicine and Obstetric, College of Medicine, Pochon CHA University, Seongnam, Korea.
Kwon
Chang Il
CI
Ko
Eun Hyang
EH
Kim
Dae Young
DY
Kim
Hyo Young
HY
Jung
Sang Hee
SH
Ko
Kwang Hyun
KH
Hong
Sung Pyo
SP
Shin
Seung Ju
SJ
Hwang
Seong Gyu
SG
Park
Pil Won
PW
Rim
Kyu Sung
KS
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D011264:Pregnancy Trimesters; D012189:Retrospective Studies
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase