| Trimester of Onset | Symptoms | Laboratory Abnormalities | Recurrence with Future Pregnancies | |
|---|---|---|---|---|
| Hyperemesis gravidarum | 1 | Nausea, vomiting | Mild to moderate elevation in AST/ALT, occasionally hyperbilirubinemia | |
| Cholestasis | 2, 3 | Pruritus, jaundice | Bile acids >8 μM, elevated AST/ALT and bilirubin in more severe cases | Common |
| Acute fatty liver | 3 | Nausea, vomiting, abdominal pain | Elevated AST/ALT (100–1000 U/L), bilirubin >5 mg/dL, prolonged prothrombin time[*] | Rare |
| HELLP syndrome | 2, 3, or postpartum | Abdominal pain, nausea, vomiting | Elevated AST/ALT (60–1500 U/L), platelets <100,000/mm3, LDH >600 U/L, hemolytic anemia | 3–25% |
Notes:
- ALT = alanine aminotransferase
- AST = aspartate aminotransferase
- HELLP = hemolysis, elevated liver enzymes, and low platelet count
- LDH = lactate dehydrogenase
Referensi:
Cecil Medicine 23rd Edition (Saunders) 2008
