Sunday, 1 December 2013

Liver diseases in pregnancy - Liver diseases coincidental with but not induced by pregnancy - part 6

Acute viral infections:

Herpes simplex virus:

It can cause fulminant liver failure and death if infection occurs during pregnancy, and the rate of transmission to the fetus can reach 30% to 50% if the primary episode occurs at delivery.
Treatment is Acyclovir 400mg thrice daily for 5 to 7 days.
About 90% of pregnant women with this infection have abnormal liver enzyme tests and an abnormal prothrombin time.
Acyclovir (FDA pregnancy category B) is very effective if promptly given at doses of 400 mg three times daily for 5 to 7 days, and early delivery is not required.

 Cytomegalovirus:

Infection may remain asymptomatic in pregnant women, and the prognosis is favorable.
The risk of transmission to the fetus and of congenital abnormalities is highest when acute infection occurs in the first 22 weeks of pregnancy.
 Termination of the pregnancy may be an option after appropriate counseling regarding the potential serious risks to the infected fetus.

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