急性脂肪肝症は、肝臓組織の脂肪の急速な蓄積によって引き起こされ、できるだけ早く発達につながる可能性があります。これはまれですが非常に危険な病気であり、しばしば第3妊娠中に現れます。危険因子：最初の妊娠、多発性妊娠（双子または三つ年を産む）、重度の子lamp前症または子lampの発症。上記の兆候に加えて、歯茎の出血の増加は特徴的です。 DICが発生した場合（血液凝固障害）、重度の子宮、食道、鼻血が始まることができます。肝不全が進行すると、毒素、特にアンモニア - 肝臓脳症と呼ばれる脳組織に浸透します。重度の場合、腎不全（肝臓症候群）が結合します。
肝内胆汁うっ滞の正確な原因は確立されていませんが、プロゲステロン分泌または感染の増加の影響について提案があります。この病気は母親から娘に伝染します。
通常、最後の妊娠中に現れます。唯一の軽度の症状は、激しい皮膚のかゆみです。複雑なケースでは、患者は深刻な衰弱と無気力、気分変動を心配しています。睡眠障害、便秘、絶え間ない胸焼け、鈍い性質の右心筋の痛みが観察されます。出生後、すべての症状は数週間以内に徐々に消えますが、その後の妊娠では繰り返すことができます。
ゲストーシスは毒性症とも呼ばれます。子lamp前症は、血圧、浮腫、タンパク尿（尿中のタンパク質の出現）の増加を組み合わせた妊娠特異的症候群です。子lampは子lamp前症の症状のある女性に発生し、痙攣性発作を特徴としています。危険な合併症はHELLP症候群です。その症状は、激しい衰弱、腹痛、頭痛、嘔吐です。彼らはすぐに視覚障害（目の前の「ハエ」、視力障害）、浮腫、腹水（腹腔内の液体）、黄undによって結合されます。それはDICと腎不全で終わり、肝臓の破裂と出血性ショック（急性失血の結果としての圧力の急激な低下）のリスクがあります。
妊婦の過度の嘔吐（1日20〜25回）は、妊娠初期に発生し、機能性障害です。ビリルビン、AST、ALT（肝臓酵素）、アルカリホスファターゼのレベルがわずかに増加しました。インジケータは、嘔吐の終了後に正常化します。
肝臓炎の妊娠中に肝臓は痛い。それらの原因は、ウイルス感染または薬物の過剰摂取（パラセタモール、メトトレキサートなど）です。
ウイルス性肝炎の中で、タイプAに最も穏やかなコースがあります。対照的に、E型肝炎がそれを引き起こす可能性があります。 B型肝炎、C-慢性疾患、増悪期間中、それらは衰弱、発熱、肝腫、黄und、右心筋軟骨の鈍い痛みによって現れます。
急性胆汁うっ滞は、胆汁が石を形成する傾向が増加するため、胆嚢を空にするのが難しいことによって説明されます（岩石性）。肝臓が増加し、黄undが現れ、右心ポコンドリウムの鈍い痛み。
バッドキアリ症候群は、肝臓からの血液の流出に関連して発生します。吐き気、嘔吐、肝腫、腹水、腹部の右上の象限の痛みによって現れます。
そのような症状が発生した場合、あなたは警戒し、産科医学者に相談する必要があります。分析と機器の研究が必要であり、そのリストを以下に示します：
The main direction of therapy for any of the complications of pregnancy is emergency delivery by caesarean section. Procrastination exacerbates the condition of the pregnant woman and the baby. Additional measures are intravenous transfusion of blood components and glucose. Treatment of gestosis necessarily includes a decrease in blood pressure (administration of magnesium sulfate).
With intrahepatic cholestasis, ursodeoxycholic acid is prescribed, the use of oral contraceptives is prohibited.
Therapy for hepatitis A is a diet, hepatitis B and C - in the appointment of interferon preparations. With toxic hepatitis, you must immediately stop contact with the poison or taking the medicine, prednisone, ursodeoxycholic acid is injected. She is also the drug of choice for acute cholestasis in combination with a diet. Surgical treatment of Budd-Chiari syndrome and liver rupture.
In a healthy woman, pregnancy proceeds without discomfort. During this period, all organs and systems should function in an enhanced mode, supporting the life of not only the mother, but also the child. In addition, they are displaced due to the growth of the fetus, and this also does not affect their work. Many women have liver pain during pregnancy, which can be caused by a number of reasons. This symptom often disappears on its own after childbirth, when the body begins to recover.
Pregnancy is a stressful period for the liver. Not only is it squeezed due to the growing fetus, it has an increased load. It normally performs several important functions:
If the liver hurts during pregnancy, this may mean that it does not cope with its functions. The amount of toxins and biological substances in the mother’s body is increasing, and she should work in an enhanced mode. In addition, during this period many chronic diseases can be exacerbated, which had not previously manifested themselves.
There are liver diseases that occur only in pregnant women. They occur in different trimesters, some then pass, and the rest require treatment. For their diagnosis, it is necessary to conduct an ultrasound examination, take blood and urine for analysis.
Preeclampsia (toxicosis) is a disease associated with impaired function of many organ systems. Doctors offer more than 30 theories of development of gestosis, but its exact cause has not yet been determined. In the first trimester, many women develop a disease called indomitable vomiting of pregnant women, which then goes away on their own. After 1-3 weeks from the onset of vomiting, signs appear that indicate liver damage:
There are 3 degrees of severity of early gestosis. The first degree is not dangerous for the woman and the fetus, since blood counts are normal. Gestosis of moderate severity is manifested by a general deterioration, the appearance of acetone in the urine. The last stage is the indomitable vomiting of pregnant women, in which the level of bilirubin and creatinine in the blood rises, and the body becomes dehydrated.
If the liver hurts during pregnancy in the later stages, this may indicate fatty degeneration. The disease develops more often at the 32nd week and later, but it is not common. Such a diagnosis is made only by one pregnant woman out of 10,000. With this pathology, fat inclusions appear in the liver tissue that do not allow her to function normally. In addition to pain in the liver, jaundice is manifested, blood and urine indicators change.
Fatty degeneration is a reversible process, but only with timely treatment
Cholestasis is stagnation of bile in the bile duct. It is called intrahepatic because bile remains in the hepatic ducts and does not enter the gallbladder. Its components are toxic and gradually destroy healthy liver tissue. Symptoms of this disease include pain in the right hypochondrium, jaundice, skin itching, and digestive upsets.
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Preeclampsia and eclampsia are serious complications of gestosis in pregnant women. These are nervous phenomena that develop against the background of brain intoxication with bilirubin and other toxic substances.
Both of these phenomena are considered life-threatening for the mother and the baby. In the last stages, if the attack cannot be stopped, the pregnant woman may fall into a coma. A characteristic sign that indicates the onset of an attack is an increase in blood pressure.
It is associated with manifestations of late gestosis and preeclampsia or eclampsia. A pregnant woman develops the so-called HELLP─ syndrome, which is expressed by a complex of pathologies:
Liver rupture is a rare complication. Small hematomas form under the capsule, under the pressure of which the liver can burst. In this case, internal bleeding occurs, and the pregnant woman needs urgent help.
Many diseases have a chronic course and are manifested by periodic relapses. During pregnancy, if the liver can not cope with increased loads, there is a risk of their complications. If such pathologies have a history, during this period you need to carefully monitor your health.
Gallstones may have a different origin and size. In most cases, attacks of cholelithiasis appear at the end of the 2nd trimester. They can cause acute pain in the right hypochondrium (), clog the bile ducts. In addition to pain, jaundice, digestive upset, and general well-being occur. The walls of the gallbladder become inflamed (acute calculous cholecystitis), and the symptoms do not disappear until the stone enters the intestines.
It is recommended to undergo a full examination at the stage of pregnancy planning to exclude the possibility of viral and other chronic liver diseases
Herpes simplex virus is considered the most common infection. The primary infection of a person occurs even in preschool age, after which the virus remains in the blood throughout life. It can cause diseases of various organs, including the liver. For the mother, the disease is not dangerous, but there is a risk of infection of the fetus in late pregnancy and during childbirth. The newborn is diagnosed with symptoms characteristic of hepatitis:
Herpes hepatitis must be distinguished from manifestations of other viral infections. If a mother gets herpes for the first time during pregnancy, little can be done to prevent the virus from being transmitted to the baby. In most cases, the disease ends in recovery, but the children are still under the supervision of a neurologist for some time because of a possible damage to the nervous system.
Budd-Chiari syndrome is called hepatic vein thrombosis. It is impossible to name its exact cause, but it is assumed that female hormones are involved in its development. This reason is an explanation of why the syndrome can occur during pregnancy. Hepatic obstruction is a serious danger to a woman's life. In addition to pain in the right hypochondrium, there is a main symptom. The veins are filled with blood and become clearly visible through the skin.
Doctors recommend undergoing a full examination at the planning stage of pregnancy, since many diseases can worsen during this period. Among the diseases that may become a contraindication of carrying a child, we can distinguish:
You need to understand that a baby will be born healthy, if during pregnancy he can develop and form normally. The liver plays one of the leading roles in the metabolism of mother and fetus. Even a previously healthy liver may not be able to cope with stress and periodically hurt during pregnancy, and if there are pathologies, there is a danger to the child. In addition, viral infections are transmitted through the placenta or with blood during childbirth.
It is especially important for the expectant mother to monitor nutrition and not to forget about physical activity
Pain in the right hypochondrium is a common symptom for a huge number of diseases. When diagnosing, the doctor draws attention to the accompanying symptoms, as well as the results of a biochemical blood test. Termination of pregnancy is recommended only in cases where there is a threat to the life of both the mother and the child, but this happens in rare cases. Basically, you can maintain liver health with medication and diet throughout pregnancy, and after childbirth, the mother’s body will gradually recover. The best option, what to do if the liver is sick, ─ consult a doctor and take tests.
You need to worry about liver health throughout your life, and not when the first symptoms have already manifested. It is recommended that the expectant mother adhere to the general rules of prevention in order to maximize the load off the liver:
If the liver hurts during pregnancy, this may be a cause for concern. In the diagnosis, the doctor pays attention not only to the pain syndrome, but also to other manifestations, and especially to blood tests. Particular attention should be paid to the health of the liver, if problems with it arose even before pregnancy ─ during this period, it may not be able to cope with the increased load. The doctor will prescribe the treatment regimen. He will find out the cause of the pain and select the drugs that are as safe as possible for the woman and the fetus.
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Pregnancy leads to a change in the hormonal and physical state of the mother. During the period of carrying the baby, the load on the work of organs and systems only increases. And the maternal organism is not always ready for this. In addition, a decrease in immunity (to avoid rejection of the fetus) can provoke an exacerbation of existing diseases and the emergence of new ones.
At the slightest worry about her health, the expectant mother should consult a doctor, especially when the liver hurts during pregnancy. Liver diseases can begin with minor pain for a long time, but lead to serious and dangerous consequences.
The causes of pain under the right rib can be both natural and harmless, as well as dangerous, risking health and life. Some of them do not require medical intervention, these are:
But there are more serious reasons. If the liver hurts during pregnancy, this may be due to the presence of previously existing diseases:
Only the attending physician can determine the cause of the pain and make a decision on its elimination. A woman alone is not able to understand what exactly led to the pathology and what to do next.
Some diseases develop only during pregnancy and some of them are potentially dangerous for the mother and fetus.
They should be considered in more detail.
Pregnancy without pathologies is characterized by timely adaptation of the work of all organs of a woman to changes in the body. First trimester toxicosis, or gestosis (toxicosis from the 24th week of pregnancy), occurs when the adaptation process is disturbed.
This problem is observed in women only during the period of bearing a child and in the early stages is characterized by:
Toxicosis begins to develop from about the fifth week of pregnancy, and stops by the thirteenth, when the placenta is finally formed. If the mother has two or more fruits, the process can drag on to 16 weeks.
When symptoms are caused only by pregnancy, then it is not dangerous. The doctor's recommendations on proper nutrition and daily routine will make life easier for the expectant mother. But with the manifestation of symptoms due to exacerbation of diseases previously existing in women, hospitalization and medical treatment may be required.
With gestosis, completely different symptoms are observed:
Gestosis is more dangerous, as it can lead to serious diseases and death of both the mother and the growing fetus.
Constant vomiting leads to an increase in the blood of the bile pigment - bilirubin, and the urine gradually turns dark. Hepatic failure develops.
With gestosis in the liver, the activity of the enzymes alanine aminotransferases (ALT) and aspartate aminotransferases (AST) increases. This can provoke a terrible liver disease - HELLP-syndrome, when there is a possibility of necrosis of the sites or rupture of the liver.
That is why any pain in the liver during pregnancy, accompanied by symptoms of toxicosis, will require close supervision by a specialist.
It appears from the third trimester of pregnancy. At this time, the production of the hormones progesterone and estrogen increases significantly, which automatically leads to increased production of bile.
The liver is quite sensitive to "pregnancy hormones", but the output of bile is inhibited. As a result, bile stasis appears in the intrahepatic bile ducts.
Symptoms of cholestasis are:
This is a rare disease in pregnant women and is not a threat to the mother. But the fetus increases the risk of fetal death, as bile acids pass through the placenta to the fetus and disrupt its development. An unborn baby may experience oxygen starvation. To prevent negative consequences, from about the 34th week, it is necessary to do artificial stimulation of childbirth.
The risk of developing the disease occurs when:
After childbirth, the disease disappears within 1–7 days, and liver activity normalizes.
Among the complications can be identified postpartum hemorrhage due to a lack of vitamin K.
The disease is rare (recorded in 11 pregnant women out of 13 thousand) and develops in the later stages.
Other names of the disease:
It is still not known why this disease begins to appear and progress, but the outcome is a great danger to both the mother and the child. During the disease, metabolic processes are disrupted in the liver, and its cells - hepatocytes - degenerate into adipose tissue without inflammatory processes.
In the development of pathology, two periods are noted. The first lasts from 14 to 40 days and is characterized by symptoms:
In the second period, yellowness of the skin begins to be noted. Hepatic failure is characterized by:
At the same time, there is a high risk of uterine bleeding and fetal death. There is a threat to life and mother.
The only treatment for this disease is emergency delivery.
The most important rule that requires strict observance is the ban on self-diagnosis and treatment. For pain in the liver, you should immediately consult a doctor (for starters, to the treating gynecologist). The specialist will make a diagnosis based on:
He will prescribe treatment or redirect to specialized specialists (gastroenterologist, hepatologist, urologist).
If a medical examination is currently not possible, you need to lie down and take a comfortable position. You can drink 0.5 cups of mineral water without gas. But then you still need to contact the clinic.
In order not to harm herself and the unborn baby, a pregnant woman should be aware of the importance of proper behavior during gestation. Measures to prevent the appearance of pathology:
Many pregnant women turn to traditional medicine if there is pain in the liver. You should not do this without the approval of a doctor, because you can greatly harm not only yourself, but also the child.