title: [Abnormal liver function tests in pregnancy: a single institution experience].
abstract: 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.
authors.affiliation: Departments of Internal Medicine and Obstetric, College of Medicine, Pochon CHA University, Seongnam, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Chang Il
authors.initials: CI
authors.lastname: Kwon
authors.forename: Eun Hyang
authors.initials: EH
authors.lastname: Ko
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Hyo Young
authors.initials: HY
authors.lastname: Kim
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Jung
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Ko
authors.forename: Sung Pyo
authors.initials: SP
authors.lastname: Hong
authors.forename: Seung Ju
authors.initials: SJ
authors.lastname: Shin
authors.forename: Seong Gyu
authors.initials: SG
authors.lastname: Hwang
authors.forename: Pil Won
authors.initials: PW
authors.lastname: Park
authors.forename: Kyu Sung
authors.initials: KS
authors.lastname: Rim
mesh_terms: 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
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase