Anaesthetic management of the pregnant patient with liver disease

SummaryThe incidence of pregnant women with liver failure presenting for delivery is fortunately rare but presents a number of complex anaesthetic problems. Liver dysfunction in pregnancy may be the result of obstetric diseases or may simply be the result of liver disease occurring in a pregnant patient. Little is currently written to advise the anaesthetist about the management of these cases. Successful anaesthetic management not only requires an understanding of the causes but also the challenges that may be encountered perioperatively. Thorough pre-operative assessment, judicious use of regional anaesthesia, and multidisciplinary care in an appropriate environment is essential for an optimal maternal outcome.