A wonderful period of pregnancy places a heavy burden on the female body. All systems begin to work hard, including the liver. The main detoxification body now has to work for two, processing the products of the fetal metabolism inside the womb. Malfunctions in the functioning of the liver cause various pathologies. One of them is hepatosis in pregnant women. The name of this diagnosis sounds intimidating and scares many women.
Description of the disease
Hepatosis is a liver disease in which the cells of an organ cease to cope with the tasks assigned to them by nature. There are 2 types of pathology characteristic of the pregnancy period:
- Cholestatic hepatosis. A common form of the disease that occurs against the background of dystrophic changes at the cellular level and metabolic disorders. The reason for this condition is hormonal changes occurring in the body of a pregnant woman.
- Acute fatty hepatosis in pregnant women is extremely rarely diagnosed, but poses a threat to the life of the mother and baby. The pathology is based on the process of replacing healthy liver cells with adipose tissue. Its development may be preceded by failures in the absorption of fatty acids, endocrine ailments, obesity, and alcohol dependence.
With the normal course of pregnancy and the absence of problems with the liver, this organ does not change in size. It retains its previous structure and optimal blood supply. However, under the influence of a number of factors, this process can fail, because along with the growth of the fetus, the load also increases. In addition, by the 12th week of pregnancy, the liver begins to produce more hormones.
An increased load can lead to the development of toxicosis in the first trimester, and in the third - to hepatosis. This condition requires constant monitoring by doctors. In especially serious cases, hospitalization may be required.
Main reasons
The exact causes leading to hepatosis in pregnant women are still unknown. Many doctors are sure that hormonal changes act as a trigger for the development of the disease. During pregnancy, the concentration of progesterones and estrogens in the blood increases sharply. Under their influence, the liver experiences a double load, which violates its functionality.
In addition, the following factors can contribute to the development of pathology:
- hereditary predisposition;
- a history of liver disease;
- malnutrition;
- uncontrolled intake of vitamins.
It often happens that a woman is diagnosed with hepatosis. However, pregnancy and childbirth are normal and without complications. In this case, the woman should be prepared for the fact that after the next conception of the child, this ailment will manifest itself again, but in a more severe form.
Clinical picture
In most cases, symptoms of cholestatic hepatosis in pregnant women appear from the 28th to the 34th week. The leading sign of the disease is skin itching. It is localized mainly in the abdomen, lower legs and forearms. Many mothers are in no hurry to consult a doctor, attributing itching to allergies. In the absence of timely treatment, it can spread to the whole body. Over time, combs begin to appear on the skin, which are very easy to infect.
In some expectant mothers, such an unpleasant symptom occurs against a background of jaundice, which is the reason for immediate hospitalization. Such patients are often diagnosed incorrectly. When compared with other diseases, then hepatosis is not accompanied by an increase in the liver and spleen, and there are no pains in the hypochondrium. Itchy skin persists until delivery. Relief occurs only after 1-2 weeks.
Fatty hepatosis in pregnant women adds signs of dyspeptic disorders. Expectant mothers complain of nausea and vomiting, decreased appetite and general weakness. The symptomatology of the disease can be latent in nature, which only complicates the timely diagnosis.
Medical examination
With hepatosis in pregnant women, it is important to identify the disorder in time in order to immediately begin treatment. However, the diagnosis of the disease is complicated by the “interesting” position of the woman. Firstly, the manifestations of pathology can be confused with other ailments. For example, toxicosis is always accompanied by nausea and vomiting, and nervous disorders and allergies are manifested by skin itching.
Secondly, some methods of examination are strictly contraindicated during pregnancy, as they can pose a threat to the development of the fetus. For this reason, expectant mothers can not do a biopsy and laparoscopy. Do not rely on palpation. The uterus, increasing day by day, blocks many organs.
When the first symptoms of pregnant hepatosis appear, you should first contact a hepatologist. He will prescribe blood biochemistry and a clinical urine test. An ultrasound examination of the liver will also be required. After confirming the diagnosis, the doctor will be able to choose the most appropriate treatment option.
Treatment features
Therapy for hepatosis can be drug or non-drug in nature. In the first case, the doctor selects homeopathic natural remedies that contribute to the normalization of the liver and the prevention of its dysfunction. In the mild form of the disease, “Urolesan”, “Hofitol” or “Hepabene” are prescribed. Dosage is selected individually. To eliminate skin itching, the following ointments are used: Nystatin, Akriderm. They should be applied twice daily to the affected area.
Treatment of hepatosis in pregnant women requires hospital conditions under the supervision of a doctor. In this case, intravenous injection of Hofitol is indicated. In addition, drugs are used to normalize the work of the gallbladder, vitamin complexes. If the patient's condition does not improve, blood purification procedures are recommended.
Non-drug treatment is based on the use of efferent therapy. It is about hemosorption and plasmapheresis. The main goal of such therapy is to restore bilirubin levels in the blood and neutralize compounds that provoke skin irritations.
Nutrition recommendations
In the treatment of acute hepatosis in pregnant women, special attention is paid to normalizing nutrition. It plays no less important role than drug therapy. Patients are recommended diet table number 5 according to Pevzner, aimed at reducing the amount of fat and cholesterol while maintaining a balance of proteins, carbohydrates. A sparing diet helps ease the work of the liver.
All fried and smoked products are prohibited. It is better to steam the dishes or bake in the oven, sometimes stew. Use preferably low-fat varieties of meat and fish. Meals should be fractional (up to 4-5 meals per day). You must comply with the drinking regimen. Drinking up to 2 liters of pure water daily is recommended. Products should be selected without chemical additives and dyes.
Carbonated drinks are also banned. To diversify the daily menu, you can use dried fruits, nuts. Food should be not only balanced, but also healthy. The diet should be followed until delivery to avoid relapse.
Help traditional medicine
Folk doctors give their advice on how to avoid unpleasant manifestations of hepatosis in pregnant women. First of all, they recommend drinking tea based on rose hips. This drink removes harmful substances from the body, improves liver function. To prepare it, you need to pour a glass of boiling water a tablespoon of chopped fruit. The liquid is insisted for at least an hour, then filtered. It is recommended to take a drink in a glass twice a day.
In the morning, you can use a sage broth. For its preparation, a spoonful of dry raw materials should be poured with a glass of boiling water, let it brew. After this, the broth needs to be filtered and cooled. Such a medicine is recommended to be used once a day. To make the broth tastier, you can add a spoonful of honey.
The consequences of the disease and its effect on the fetus
Timely detected and cured disease does not pose a threat to a woman's life. All unpleasant symptoms, as a rule, disappear a few weeks after the birth.
The greatest danger is represented by disorders in the blood coagulation system that occur due to hepatosis in pregnant women. The consequences of the disease are manifested in a high risk of bleeding. They are possible both during the period of bearing the child, and in the process of childbirth.
The disease adversely affects the condition of the fetus. Children whose mothers suffered from symptoms of hepatosis during pregnancy usually are born with insufficient weight or developmental delay. Quite often, such births end prematurely. This situation entails the appearance of certain problems typical of premature babies. CNS pathologies, respiratory disorders, malfunctions of the visual apparatus - this is just a small list of the effects of hepatosis on a child. That is why gynecologists are trying hard to keep the pregnancy and bring it to a minimum period of 36 weeks.
How to give birth with hepatosis?
Many expectant mothers are interested in a very logical question: is it possible to give birth with hepatosis? It is definitely difficult to answer it, because each case is considered individually. The issue of delivery depends on the condition of the woman herself and her baby. If the baby develops normally, childbirth takes place on time and in a natural way.
The progression of the disease, severe skin itching or the appearance of bleeding complicate the situation somewhat. When these violations appear, early delivery is recommended. There are 2 possible options: cesarean section surgery or labor stimulation.
Prevention Methods
To avoid the complicated course of pregnancy, even at the planning stage, you need to undergo a comprehensive examination of the body. With various liver pathologies, it is better to cure them immediately. This must be told to the gynecologist. Also, at the doctor’s appointment, it is necessary to mention all chronic ailments, hereditary diseases. Only in this case can we hope for a favorable pregnancy outcome.