XXXX : current opinions and management.

@entity1 @entity3152 @entity13359 @entity1910 @entity2209 @entity409 @entity147 @entity111 @entity134 @entity1448 @entity6741 @entity3645 @entity204 @entity1370
@entity13359 ( @entity13359 ) is a pregnancy-specific liver condition that typically presents with generalised @entity111 in the absence of a @entity1910 in the late second trimester or third trimester. It is more common in certain ethnic groups, particularly those from South Asian, South American, Nordic and Scandinavian regions, and has a familial and genetic basis. Recent research suggests that the pathophysiology may reside in mutations in genes that code for @entity6741 transporter proteins. Mutations involving the @entity6741 transporters may impair maternal excretion and influence transplacental passage of @entity3645 . It is hypothesised that the surge in pregnancy @entity134 hormones may result in genetically predisposed @entity1 developing @entity1448 . The condition is also associated with increased perinatal morbidity and mortality, particularly from @entity3152 , @entity147 and intrauterine @entity204 . Animal studies have shown that @entity3645 are @entity1370 , which may help explain the condition's association with @entity147 and @entity2209 . Accurate diagnosis relies on a high index of suspicion, and the findings of @entity409 tests and raised serum @entity6741 levels after the exclusion of other organic causes of @entity409 . Ursodeoxycholic acid helps relieve symptoms, improve serum @entity6741 levels and possibly has a cardioprotective effect. Active management, in the form of close antepartum fetal monitoring and delivery before 37 weeks, helps to decrease the risk of intrauterine @entity204 , though possibly at the expense of increased obstetric intervention. Following delivery, there is usually a dramatic improvement of symptoms and resolution of the condition. @entity1 should be counselled about the high recurrence risk of @entity13359 in subsequent pregnancies.
