PubMed · 9641026
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G Choudhuri, A Srivastava. Biliary microlithiasis.. https://pubmed.ncbi.nlm.nih.gov/9641026/
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Acute viral hepatitis is the most common cause of jaundice in pregnancy. The course of acute hepatitis is unaffected by pregnancy, except in patients with hepatitis E and disseminated herpes simplex infections, in which maternal and fetal mortality rates are significantly increased. Chronic hepatitis B or C infections may be transmitted to neonates; however, hepatitis B virus transmission is effectively prevented with perinatal hepatitis B vaccination and prophylaxis with hepatitis B immune globulin. Cholelithiasis occurs in 6 percent of pregnancies; complications can safely be treated with surgery. Women with chronic liver disease or cirrhosis exhibit a higher risk of fetal loss during pregnancy. Preeclampsia is associated with HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome, acute fatty liver of pregnancy, and hepatic infarction and rupture. These rare diseases result in increased maternal and fetal mortality. Treatment involves prompt delivery, whereupon the liver disease quickly reverses. Therapy with penicillamine, trientine, prednisone or azathioprine can be safely continued during pregnancy.
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The low threshold for sonographic examinations of the gallbladder, the relative high incidence of gall bladder disease and the extraordinary quality of ultrasound imaging leads to a remarkable number of chance findings. The image quality of new ultrasound scanners allows in most cases a rapid diagnostic decision. Therapeutic consequences depend in the first line on the following carefully directed anamnesis. The most common findings are gallstones, cholesterinosis, polyps and sludge. Rare but important findings are porcelain gallbladder, adenomyomatosis and cysts of the common bile duct.