Biochemical changes:
The total serum protein concentration declines approximately 20% in midpregnancy, primarily as a result of the substantial decline in serum albumin which may be attributed to simple dilution caused by the increase in total blood volume, although most other serum proteins either remain unchanged or increase in concentration.
A significant rise in serum fibrinogen regularly accompanies pregnancy, as a consequence of increase fibrinogen synthesis.
Other coagulation proteins, including factors VII, VIII, IX, and X, may be increased during pregnancy or after estrogen treatment.
And increased serum bilirubin level in pregnancy should be considered presumptive evidence for the presence of liver or hematologic disease.
Alkaline phosphatase activity is increased during the third trimester both because of leakage of placental alkaline phosphatase into the maternal circulation and because of increased maternal bone turnover.
Serum bile acid level is quite helpful in any form of cholestasis. The serum level is normal in normal pregnancy.
Levels of serum AST and ALT are normal in normal pregnancy.
The ALT is especially useful, because significant elevation of this enzyme does not occur with injury to tissues other than liver.
The total serum protein concentration declines approximately 20% in midpregnancy, primarily as a result of the substantial decline in serum albumin which may be attributed to simple dilution caused by the increase in total blood volume, although most other serum proteins either remain unchanged or increase in concentration.
A significant rise in serum fibrinogen regularly accompanies pregnancy, as a consequence of increase fibrinogen synthesis.
Other coagulation proteins, including factors VII, VIII, IX, and X, may be increased during pregnancy or after estrogen treatment.
And increased serum bilirubin level in pregnancy should be considered presumptive evidence for the presence of liver or hematologic disease.
Alkaline phosphatase activity is increased during the third trimester both because of leakage of placental alkaline phosphatase into the maternal circulation and because of increased maternal bone turnover.
Serum bile acid level is quite helpful in any form of cholestasis. The serum level is normal in normal pregnancy.
Levels of serum AST and ALT are normal in normal pregnancy.
The ALT is especially useful, because significant elevation of this enzyme does not occur with injury to tissues other than liver.
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