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Liver Disease in Pregnancy / R.J. Hilsden and E.A. Shaffer page 552 17.1 Normal Pregnancy heart The pregnant state normally is mildly cholestatic from the increase heart in endogenous estrogens. This changes several biochemical tests, but primary liver disease is an uncommon complication. When features of liver disease do occur during pregnancy, prompt evaluation is essential as some conditions, such as acute fatty liver of pregnancy, rapidly progress to become fatal to both mother and fetus. The anatomic and physiologic changes that accompany pregnancy alter physical findings and liver biochemistries. Yet normal pregnancy does not heart significantly affect liver metabolism or function. Pregnancy does not change liver size. In the third trimester, the enlarging uterus displaces the liver superiorly and posteriorly. Therefore, a palpable liver suggests significant hepatomegaly and underlying liver disease. A small amount of peripheral edema is also common during pregnancy, as are some findings that usually connote chronic liver disease, such as spider angiomas and palmar erythema.
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