Hyperemesis, gastro-intestinal and liver disorders in pregnancy

This review aims to discuss some of the common and serious conditions of the gastro-intestinal, hepatic and biliary tracts in pregnancy. Hyperemesis gravidarum is a condition which can lead to serious complications such as Wernicke’s Encephalopathy. Hepatic disorders specific to pregnancy such as the HELLP syndrome (haemolysis, elevated liver enzymes and low platelets) and Acute Fatty Liver of Pregnancy (AFLP) are discussed. Management of Obstetric Cholestasis is also covered. Some forms of Hepatitis can be much more severe in pregnancy such as Herpes Simplex and Hepatitis E. The course of inflammatory bowel disease is generally unaffected by pregnancy and but flares should be managed as in the non-pregnant patient. Knowledge of the treatment options available and their safety in pregnancy is important to ensure these patients are adequately treated. Conditions such as appendicitis may have an atypical presentation in pregnancy and therefore diagnosis may be delayed.