It is no secret that during pregnancy a lot of changes occur in a woman’s body. Often pains occur in those places and organs that previously did not disturb the expectant mother.
One of the most important organs of the body is the liver. During the period of gestation, it is she who is responsible for cleansing the body of the mother and baby, and this means that the load on her doubles. Therefore, women may note that they have liver pain during pregnancy. Consider what needs to be done in such a situation, what treatment to carry out, what tests to take.
Features
Liver problems can make pregnancy worse, causing unwanted complications. Sometimes it happens that the function of this organ is disturbed slightly, and after the birth of a child its functioning is restored.
If there are chronic liver diseases in the medical history, then the entire pregnancy will have to be under the strict supervision of a specialist.
Physiological causes of pain
As already mentioned, a woman’s body undergoes many changes, certain types of metabolism (fatty, protein, carbohydrate) are violated, which leads to an increase in the load on the liver. As a result, all this causes pain.
In late pregnancy, the baby usually moves a lot in the stomach. He purely by chance can touch the liver, thereby causing aching pain in the right side. Some women may complain of nausea, heartburn, and lack of appetite.
With the growth of the child, the uterus also increases, which can create pressure on the liver. Some future mothers have biliary dyskinesia. As a result, the exit of bile and the work of the bile ducts as a whole are disrupted. But this does not negatively affect the fetus. After the birth of the child, the functioning of the gallbladder is restored.
Improper nutrition and disruption of the digestive system can also be one of the causes of pain. During the period of carrying the baby, women are not always choosy in terms of food that they eat in large quantities, which adversely affects the liver.
With a normal pregnancy, the blood supply to the liver and its size are practically unchanged. But all these criteria are monitored by the lead physician.
Pathological causes
A problem can be a sign of chronic illness. During pregnancy, exacerbation of gallstone disease (stones in the gallbladder and its ducts) is sometimes observed, which causes colic. Changes in hormonal levels can also cause stone formation. The pain is very acute.
Another reason is intrahepatic cholestasis of pregnant women. Most often, this pathology is observed in the third trimester. Due to an increase in the level of sex hormones, the formation of bile increases, and its secretion is inhibited.
This disease is accompanied during pregnancy by nausea, bitterness in the mouth, itchy skin, pain in the right hypochondrium. Many women experience vomiting. Itching begins with the limbs, feet, and then extends to the entire body. Urine also darkens and feces lightens. After childbirth, everything returns to normal again.
Another symptom of liver problems is yellowness of the skin and sclera. This symptom may indicate hepatitis. During pregnancy, a virus test for this disease is required. While the baby is in the stomach, infection will not occur, but it is possible during childbirth, although the probability is small.
Indomitable vomiting may be a signal for increased bilirubin due to impaired liver function. Heart failure may also be the cause, as blood is poorly pumped and accumulates in the liver and lungs. Some old injuries can also cause pain in the liver.
Hepatitis
These diseases are infectious and non-infectious in nature. With hepatitis, the organ’s nutrition is disrupted, its cells are destroyed.
There are seven types of hepatitis, indicated by Latin letters. The most dangerous in terms of virulence A and E, since these viruses can be infected not only from a patient or a virus carrier, but also through the fecal-oral route. This means that microbes can enter the body of a pregnant woman with unwashed foods, dirty hands, untreated water.
The remaining types of hepatitis occur only upon contact with the patient, blood transfusion, or any manipulation of a poorly processed instrument (for example, during a visit to the dentist).
Hepatitis C is considered a very dangerous disease, since without treatment it can lead to cirrhosis. If the infection occurred during pregnancy, then this can cause fetal death or death of the baby a few days after birth.
All types of hepatitis adversely affect the development of the fetus, lead to impaired blood circulation and blood clotting, which leads to serious consequences. If such a disease is diagnosed in a pregnant woman, then the child is vaccinated immediately after birth. In 95% of cases, the disease in infants does not develop.
Diagnostics
According to statistics, 2-3% of pregnant women suffer from hepatocholecystitis, hepatitis or gallstone disease. Only with proper diagnosis and therapy, the bearing of the baby will end with normal physiological birth. Therefore, if unpleasant symptoms occur, you should immediately consult a gynecologist.
The doctor directs the patient to a general clinical blood test to check the level of red blood cells, hemoglobin, white blood cell count. These indicators help to detect inflammatory diseases in the body.
Next, a biochemical blood test is performed:
- ALT and AST are indicators of liver health. Normally they are equal to 31 U / l. In the presence of unpleasant sensations in the liver, poor tests during pregnancy are an indicator of ALT and AST above 31 U / L. This result indicates violations in the work of the body.
- Bilirubin is common. Norm 5 - 21 μmol / l. If the numbers in the analysis are higher than normal, then this may indicate liver damage or jaundice.
- Bilirubin is direct. Norm 0 - 7.9 μmol / L. The value may increase with pregnant jaundice, stagnation of bile, liver damage.
Markers of viral hepatitis B and C are also determined. Usually, a test for hepatitis B is done at the beginning of pregnancy, but if a woman visited a nail salon, a dentist, underwent injection treatment, then the analysis must be repeated.
Also, for pain in the liver, an ultrasound of the liver is prescribed during pregnancy. This study helps to detect inflammatory processes in the organ, determine its size, check the condition of the gallbladder and ducts.
To diagnose gallbladder dyskinesia, check its size before and after a special breakfast, which usually consists of 2 raw egg yolks. Using this method, you can confirm or deny the presence of stones in the gallbladder and the absence of inflammatory diseases. Intrahepatic cholestasis of pregnant women is quite difficult to establish. Usually this conclusion is reached after the exclusion of other possible complications.
If a woman is concerned about itching (the very first symptom of cholestasis), she goes to a dermatologist. The doctor prescribes the necessary tests, including a liver test and determination of bile acids. The results of these analyzes may be negative. To clarify the picture, they can be re-appointed. If this time, no deviations are found, a diagnosis of pregnant cholestasis is made. When conducting a liver test, an increase in direct bilirubin, triglycerides and globulins can be a marker of cholestasis.
Therapies
Treatment of the liver during pregnancy is prescribed by a doctor. It directly depends on the pathology that causes the discomfort.
Treatment of biliary dyskinesia
The goal of therapy is to normalize the outflow of bile in order to avoid its stagnation. One of the most important points is proper nutrition.
Food should be taken in small portions, 5-6 times a day. Into the diet should be introduced foods that promote the outflow of bile.
These include meat or fish broths, eggs, sour cream, cream, butter and vegetable oil. Cottage cheese, broth of wild rose, cod, bran, cabbage, carrots are useful. In general, food rich in fiber and magnesium is needed.
The second step is the use of choleretic drugs. Most often prescribed fees or teas. The choleretic collection includes immortelle flowers, yarrow grass and coriander fruits. If this is tea, then the composition may include tansy, corn stigmas, rose hips.
In the second half of pregnancy, with the development of edema, it is convenient to use Flamin, which is a dry concentrate of immortelle flowers. Take 1-2 tablets from the liver during pregnancy 3 times a day for half an hour before meals. Also a good drug is Holosas, which is taken one teaspoon 3 times a day.
Hepatitis treatment
During pregnancy, this disease is not treated. To maintain health, the expectant mother must follow a diet and daily routine.
Usually, therapy is postponed for the period after childbirth, because the baby cannot get infected in utero. Therefore, immediately after the birth of the baby, the necessary course of therapy is prescribed.
Pregnant intrahepatic cholestasis treatment
In the presence of this disease, it is necessary to strictly watch what kind of food the pregnant woman consumes. Fatty foods, smoked meats and pickles should be excluded from the diet. Drinking more fluids is also recommended. In addition, Vitamin K is prescribed to prevent postpartum hemorrhage.
One of the symptoms of this disease is itching. It will not work out completely, but you can reduce it. To do this, apply Kalamin Lotion or baby creams with calendula. Clothing must be worn lightweight, made of cotton. This will help prevent itching.
Drug therapy and treatment with liver pills should be supported by diet. The diet should have a lot of protein foods, vitamins. After childbirth, women who have had this disease are registered at the antenatal clinic.
Foods to eat
The list of products for the liver is diverse. Be sure to eat more vegetables, cereals, drink vegetable juices. For example, carrot prevents the development of fatty liver.
Cholesterol-rich foods should be excluded. It is better to include vegetable fats (nuts or sunflower seeds) in the diet. From animals suitable butter or ghee.
Conclusion
For pain in the liver, be sure to consult a doctor. If it is necessary to undergo a course of treatment, it is not recommended to refuse it.
You should always remember that a timely visit to a specialist will help to avoid undesirable consequences. It is impossible to ignore pain in the liver. It is also very dangerous for mom and the unborn child to self-medicate.