Z Gastroenterol 2017; 55(08): e57-e299
DOI: 10.1055/s-0037-1605264
Kurzvorträge
Ultraschall und andere schnittbildgebende Verfahren
Spezieller gastroenterologischer Ultraschall – Kolon, Leber und mehr: Freitag, 15 September 2017, 16:25 – 17:37, Rotterdam/Forschungsforum 2
Georg Thieme Verlag KG Stuttgart · New York

Liver stiffness reversibly increases during pregnancy

JF Ammon
1   Heidelberg University Women's Hospital, Department of Obstetrics and Gynecology, Heidelberg, Deutschland
2   Salem Medical Center, Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Heidelberg, Deutschland
,
A Kohlhaas
2   Salem Medical Center, Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Heidelberg, Deutschland
,
C Sohn
1   Heidelberg University Women's Hospital, Department of Obstetrics and Gynecology, Heidelberg, Deutschland
,
HK Seitz
2   Salem Medical Center, Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Heidelberg, Deutschland
,
T Bruckner
2   Salem Medical Center, Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Heidelberg, Deutschland
,
G Fluhr
2   Salem Medical Center, Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Heidelberg, Deutschland
,
H Fluhr
1   Heidelberg University Women's Hospital, Department of Obstetrics and Gynecology, Heidelberg, Deutschland
,
S Mueller
2   Salem Medical Center, Department of Medicine and Center for Alcohol Research, Liver Disease and Nutrition, Heidelberg, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
02 August 2017 (online)

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Background:

Several life threatening but poorly understood hepatic complications are associated with pregnancy such as the HELLP syndrome, pregnancy-related cholestasis or eclampsia. Liver stiffness (LS) has evolved as a novel important diagnostic parameter to screen for liver diseases. We here study the LS during pregnancy and after delivery and its relation to various maternal and child-related factors.

Methods:

In the learning cohort, LS was measured by Fibroscan (Echosens) in 103 pregnant women in the second and third trimester who presented during routine follow up of pregnancy. In the validation cohort, LS was measured in further 305 pregnant women whom presented at a tertiary delivery center. 28 women had liver disease (9%) and LS could be measured post partum in 52 women.

Results:

All women could be measured with the M probe (93.3%) or XL probe (7.3%). In the learning cohort, 17 women (16.5%) had a pathological LS higher than 8 kPa, four of them higher than 12.5 kPa which is regarded as cut-off value for F4 fibrosis. In healthy women of the validation cohort, 220 of 277 women had a normal LS< 6 kPa (79.4%), 12 women (4.3%) had a pathological LS higher than 8 kPa, 3 of them (1.1%) higher than 12.5 kPa. In healthy women mean LS increased markedly starting from gestational week 27. Mean LS per trimester was 4.4 kPa (I), 4.5 kPa (II) and 6.2 kPa (III). About 45% of the women in the final trimester had LS elevation. In the women with follow-up measurement post partem, mean LS of 6.0 kPa significantly decreased to 4.0 kPa two days after delivery (P < 0.001). Women with additional confounding liver diseases had significantly higher baseline LS (11.2+/-14.5 kPa) that fell to 6.0+/-3.0 kPa after delivery. In healthy women, LS elevation correlated significantly with current body weight (0.287, P < 0.001) and body weight before pregnancy (0.161, P < 0.001).

Conclusion:

LS significantly increases during pregnancy namely in the third trimester but completely normalizes within two days after delivery. Since LS elevation is related both to maternal and child-related factors, it could be an important novel non-invasive predictor of hepatic complications during pregnancy.