Physiology
This hormone causes relaxation of the esophogeal sphincter and biliary tract.
What is Progesterone?
Too much of this commonly used over the counter medication can cause liver failure
What is acetaminophen?
Itchy palms and soles are hallmarks of this hepatic disease in pregnancy
What is Intrahepatic cholestasis of pregnancy?
The most commonly reported blood borne infection in the US
What is Hepatitis C?
Routine screening for hepatitis at the first ob visit includes ordering these labs.
What is Hepatitis B surface antigen (HepBsAg) and what is Hepatitis C antibody
What is Estradiol and hCG?
This medication is commonly used to treat ICP however a recent large RCT called into question its use to improve perinatal outcomes.
What is ursadiol?
In a recent systematic review of ICP, the risk of stillbirth was significantly increased above what maternal value of bile acids?
What is 100 umol/L?
The vertical transmission rate of this viral hepatitis is as high as 90% without prophylaxis in women with active infection.
What is Hepatitis B?
Co-infection with this virus increases the vertical transmission rate of Hepatitis C
What is HIV?
This liver function test is commonly elevated in the third trimester of pregnancy
What is alkaline phosphatase?
Use of a metoclopramide and phenothiazine medications increase the risk of this.
Extrapyramidal symptoms such as tar dive dyskinesia
ICP recurs in this proportion of pregnant women in a subsequent pregnancy.
What is 60% to 90%?
This is a hallmark finding in acute fatty liver of pregnancy so don't forget to order your BMP.
What is Hypoglycemia?
UNC hematologists want these tests before referral for a postpartum woman with Hepatitis C.
What is a liver ultrasound, genotype, HBV viral load and LFTs?
This is thought to be the mechanism of stillbirth in ICP.
How do bile acids affect fetal myocytes?
This HIV medication is used to treat some pregnant women with Hepatitis B.
What is tenofovir?
This blood test can help diagnose acute fatty liver of pregnancy, but don't forget to but the vial on ice!
What is ammonia level?
Vertical transmission rates of Hepatitis C in pregnancy.
What is 5%.
A rare complication of HEG that results from deficiency of Vitamin B1
What is Wernicke encephalopathy?
Serotonin 5-HT3 inhibitors given with a variety of medications including antihistamines, diuretics, and antidepressants may cause this problem
What is QT prolongation?
Improvement in maternal itching after administration of UDCA is typically seen after how long
What is 1-2 weeks?
The CDC recommends babies get the HBIG shot and the first dose of hepatitis B vaccine within this timeframe of being born.
What is 12 hours?
Given to health care workers, IVDU, and should be given to pregnant women without immunity.
What is the hepatitis B vaccine?
2 single antigen vaccine are available either 2-3 doses
First line medication for N/V of pregnancy
Pyridoxine (Vitamin B6) or Vitamin B6 with doxylamine [10mg for each q 8 hours]
For pregnant women with Hepatitis B who do not meet criteria for antivirals, we now recommend these tests at 26-28 weeks.
What is a viral load and Hepatitis e antigen?
•Antiviral therapy recommended if ALT > 2x UL of normal and elevated HBV DNA (>20,000 IU/mL in HBeAg + pts or >2000 IU/mL in HBeAg - pts)
•Re-check HBV DNA level at 26-28 weeks > recommend antiviral therapy per guidelines (viral load > 2 x 10^5 IU/mL)