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Dr. Andrew Rynne

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Pregnant and had liver function test. Need second opinion regarding the test report

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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6011 Questions

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Posted on Tue, 10 Dec 2013 in Liver and Gall Bladder
Question: Hi, My wife is 37 week pregrant, he is having itching problem, we have consult our Doctor, she has suggested to go for Liver Functional Test, after the test we are seeing below parameter are high SGOT 182 U/L, SGPT 247U/L, ALKALINE PHOSPHATASE( ALP) 278 U/L & GAMMA GT (GGT) 163 U/L But she is telling its not alarming, there would be not risk, We are looking for some second suggestion. Please advice Also, she is telling, if itching problem is very high, we can have delivered in 38 week.
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Answered by Dr. Aarti Abraham 1 hour later
Brief Answer: CHOLESTASIS OF PREGNANCY - TREATMENT IS REQUIRED. Detailed Answer: Hello Mr. XXXXXXX Thanks for writing to us with your health concern. I have gone through the reports provided. Your wife is suffering from a condition known as " Obstetric Cholestasis " or " ICP - Intrahepatic Cholestasis of Pregnancy ". Due to the pregnancy hormone progesterone, the liver becomes weak in its ability to metabolize and dispose of bile salts . Due to this, bile salts get deposited underneath the skin surface, leading to itching. THis condition definitely carries risks - mainly to the baby. There is a risk of sudden intra uterine death of the baby in this condition, alongwith chance of preterm labour and sudden separation of the placenta leading to bleeding ( abruption ). For such a patient, I would prescribe Udiliv ( 300 ) twice a day , as it contains the supportive liver enzymes. ALso, i would prescribe local Lacto Calamine lotion for application to control itching along with Cetirizine tablet daily at night. She should avoid scratching too much . ALso, the liver function tests should be repeated in a week. If the report is still the same ( no improvement ) and itching is not relieved, then delivery is indicated at 38 weeks to prevent any risk to the baby. Also, she should carefully count baby's movements daily. After breakfast, lunch and dinner , she should lie in the left lateral position for 1 hour ( total 3 hours a day ) and count the movements. If the total is less than 10, she should report to the doctor. Also, she should undergo fetal ultrasound with Colour Doppler to know if the baby is fine. Take care. Please feel free to ask for further clarifications.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Aarti Abraham 1 hour later
Thanks Dr XXXXXXX She took the Udiliv 300mg twice a day around 4 weeks before then the count of the parameter came down, After that she stopped the udiliv medicine, then again these count went up. She again started now taking the same thrice a day as prescribed by her doctor. Baby movement count seems to be OK, doctor has advices to take a NST(baby's heart beat) this week so that next week we may under a induce delivery. Please let us know is there any risk to Baby?? Is there any side effect due to Citrizen or udiliv, as she is taking these almost everyday?
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Answered by Dr. Aarti Abraham 42 minutes later
Brief Answer: TAKE CARE. Detailed Answer: Hello again. Thank you for providing the detailed history . There is no side effect to Cetirizine or Udiliv, do not worry. NST is recommended, so please go for it. Delivery should definitely be induced at 38 weeks, as she is facing this problem since a month. As I said, there is always a risk of sudden intra uterine death, so vigilant fetal movement counting should be done. All the best to you, and take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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