Publication Date
3-1-2024
Journal
Case Reports i Women's Health
DOI
10.1016/j.crwh.2024.e00587
PMID
38515998
PMCID
PMC10955193
PubMedCentral® Posted Date
2-6-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Preeclampsia, Hypertensive disorders of pregnancy, Chronic liver disease, Maternal-fetal medicine, Cirrhosis, Liver dysfunction
Abstract
Preeclampsia and decompensated chronic liver disease are known triggers of acute hepatic dysfunction in pregnancy, rarely including hepatic encephalopathy. Differentiating the driver of acute hepatic dysfunction in patients with concomitant preeclampsia and preexisting liver disease presents a diagnostic challenge with important management implications.
A 42-year-old woman, gravida 3 para 0201, at 24 1/7 weeks of gestation presented with hepatic encephalopathy, transaminitis, and hyperbilirubinemia in the setting of cirrhosis and severe new-onset preeclampsia. The preeclampsia was thought to be the leading etiology of hepatic encephalopathy, prompting emergent Cesarean delivery at 24 2/7 weeks. Hepatic encephalopathy, blood pressure, and laboratory derangements improved promptly post-delivery.
Preeclampsia can trigger acute hepatic dysfunction, including hepatic encephalopathy, in the setting of previously compensated preexisting liver disease. Recognizing this association has important implications for management and treatment.