. Author manuscript; available in PMC: 2021 Sep 29.

Published in final edited form as: Anesth Analg. 2021 Jul 1;133(1):80–92. doi: 10.1213/ANE.0000000000005433

Table 3:

Laboratory abnormalities and symptoms of different liver and biliary diseases unique to pregnancy

Disease	Trimester	Laboratory Abnormalities	Symptoms
Intrahepatic cholestasis of pregnancy	2^nd or 3^rd	Increased bile acids Increased bilirubin Increased GGT and ALP	Jaundice and itching
Hyperemesis gravidarum	1^st	Increased AST and ALT Increased bilirubin Electrolyte abnormalities associated with vomiting Increased thyroid function	Severe nausea and vomiting Jaundice
HELLP	2^nd or 3^rd	Low hemoglobin Low platelets Increased AST and ALT Increased creatinine Increased uric acid Increased LDH	Hypertension Abdominal pain Headache Nausea Edema
AFLP	3^rd	Increased AST and ALT Increased creatinine Hypoglycemia Increased bilirubin Increased ammonia Increased LDH Increased uric acid Prolonged PT and PTT Low fibrinogen	Anorexia Nausea Malaise Fatigue Headache Jaundice Encephalopathy Edema

AFLP: acute fatty liver of pregnancy; ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; GGT: gamma glutamyl transferase; HELLP: hemolysis, elevated liver enzymes, and low platelets; LDH: lactate dehydrogenase; PT: prothrombin time; PTT: partial thromboplastin time.