The Hepatic Hijack: How Pregnancy Affects Liver Disease: Case Series

Liver diseases in pregnancy may be categorized into liver disorders that occur only in the setting of pregnancy and liver diseases that occur coincidentally with pregnancy. Out of all diseases Intra hepatic cholestasis of pregnancy is most commonly seen usually in third trimester and resolves post delivery with medication. Intrahepatic cholestasis of pregnancy (ICP) is a liver disease specific to pregnancy. ICP IS usually seen during the second or third trimester of pregnancy and improves automatically after delivery. ICP has been identified worldwide, but its prevalence varies considerably depending on country and ethnicity. The role of clinical suspicion, early diagnosis, variable presentation of patient, proper management and proper followup is being studied in this case series. Methods: This study was a retrospective observational study, carried out in the R L jalappa hospital and research centre kolar karnataka. Status of women who had liver diseases during their pregnancy. This was studied between December 2024 and February 2025 after taking exclusion and inclusion criteria into consideration. Following details were noted which included clinical history, examination, investigations and treatments including operative reports and management were reviewed and surgical outcomes were obtained. Results: 4 cases of liver diseases in pregnant females were identified from Dec 2024 to Feb 2025.4 patients were diagnosed as Intrahepatic cholestasis of pregnancy.All the 4 patients presented with complaints such as itching all over body more on palms and soles and pain in the right upper quadrant of abdomen.All the 4 patients were diagnosed by evaluating serum LFT and serum bile acids levels.All patients were treated by giving Tab.UDILIV 300MG Orally BD,Tab RIFAGUT 550 MG RT BD ,HEPAMER Q SACHETS orally TID along with intake of plenty of oral fluids.Usually by the end of 1 week or by 10 days of delivery of fetus which is either by vaginal delivery or caesarean section majority of the symptoms subsided. Conclusion: Intrahepatic cholestasis of pregnancy is a common hepatic disorder associated with pregnancy. Pruritus, developing most commonly in third trimester of pregnancy, is the most specific clinical symptom. The resolution of symptoms is seen most commonly after the delivery. Laboratory diagnosis is mainly based on elevated total Liver function tests especially ALT and serum bile acids levels in the maternal blood. The mainstay of therapeutic management consists in the reduction of maternal symptoms by using Urso deoxy cholic acid.In my study there is significant reduction of maternal symptoms after delivery of fetus and usuage of tablet ursodeoxy cholic acid. Maternal outcomes have good prognosis but fetal outcomes can be improved by timely and effective intervention which is usually possible in tertiary care centres as shown in my study.