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Child birth, mild hypertension, elevated liver function tests, edema, elevated CRP. Treatment ?

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My daughter gave birth on 6/15 and now has mild hypertension, elevated liver function tests and edema....the baby had an elevated CRP with negative blood cultures and is receiveing antibiotics for one there any connection? What questions should I ask when I go to the hospital today? Thank you
Posted Sun, 6 May 2012 in Child Health
Follow-up: Child birth, mild hypertension, elevated liver function tests, edema, elevated CRP. Treatment ? 4 minutes later
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Answered by Dr. Robert Galamaga 20 minutes later

Thank you for your query.

The symptoms which your daughter is experiencing are typically part of a syndrome which is seen during late pregnancy. Sometimes however this can be seen right at childbirth. As you mentioned her blood pressure is elevated and she has abnormal liver function tests in addition to having edema. This again is part of the syndrome which usually will resolve with some time. I would be also interested to know if she has a normal platelet count. If her platelets are normal then this is a less severe type of syndrome.

This is generally treated with supportive measures. She may be given some medication to bring her blood pressure under better control. Sometimes also a diuretic medication may be given to help lessen the edema. This may take a number of days to completely resolve.

As for the baby the elevated test which you mentioned sometimes reflects an infection. I would be interested to know and you can possibly ask the doctors if the blood cultures or any other cultures which they have checked have come back positive for any type of bacteria or virus. For now it sounds like they are treating the baby with antibiotics that will cover it the most likely causes of a bacterial infection at this point in the baby's life.

As far as questions which I think you should be attentive to when you visit your daughter I would recommend that you inquire about her vital signs. Hopefully the trend in her blood pressure is that it is improving. In addition I would try to ask the physicians if her blood counts and coagulation factors are normal. Sometimes this can be disturbed in this syndrome. Finally I would inquire as to how her liver enzymes are looking today verses previously.

I do not think there is any obvious connection between what is going on with your daughter and the elevated blood test which you mentioned in the baby.

I can appreciate that this is a very stressful situation for you and the family. Let me reassure you however that most likely your daughter and the baby will be fine.

Again I thank you for submitting your question. If you have follow-up questions I am available to address them.


Dr. Robert.
Above answer was peer-reviewed by
Follow-up: Child birth, mild hypertension, elevated liver function tests, edema, elevated CRP. Treatment ? 27 minutes later
Thank you-just got text that her LFTs shot up again this morning. Platelets normal. Highest BP was 150/104. Is this likely to occur with another pregnancy? She will not be discharged today as planned. They are not planning on giving her a diuretic at this point as the BP has trended down.
She had R sided pain throughout her pregnancy, assumed related to "growing" pains, could she have had some liver inflammation during pregancy? Was going to do an US, I assume to check for GB disease? Thank you so much, sorry that's more than one question...

Babe's blood cult were negative and she is eating well and will come off IV today. She was hypoxic at 80% at first, now off O2. I think too she is doing great, more concerned about the symptoms and syndrome of my daughter at this point.
Answered by Dr. Robert Galamaga 13 hours later
Hello again.

This does not necessarily mean she is at risk for this syndrome in subsequent pregnancies. I am glad to hear at least that her symptoms are leveling off. The LFTs may bounce a bit for the next week or so but as long as there is not a sign of liver failure then she should be fine. The liver is a very resilient organ and can endure through these kinds of syndromes among other things such as infections or medications which sometimes affect liver function.

As for the pain she had - I think it's unlikely to be related to the liver unless she had some evidence of obstruction of the flow of bile which it sounds like is not the case. An ultrasound can assess for this and also for the possibilty of gallstones which cause right upper quadrant pain.

I am thrilled to hear baby is doing well also. I anticipate you will all be home to celebrate the new arrival very soon. Your daughter will go for followup visits to make sure the liver fully recovers - and I am sure it will.

Thank you again for the query. I am happy to answer any additional followups as well.

Take care,

Dr. Robert

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