Manav Wadhawan, K Singh, Kanwal Gujral, Premashish Kar, Gaurav Pandey, Ankur Kumar Jindal, Padaki Nagaraja Rao, YK Chawla, Nirupama Trehanpati, Kaushal Madan, Ajay Duseja, Chundamannil E. Eapen, Aparna Sharma, Shiv Kumar Sarin, Anil Arora, Ashok Kumar, K. T. Shenoy, Vinod Kumar Dixit, Subrat K. Acharya, Neelam Aggarwal, Krishna Kumari, Pankaj Puri, Anoop K. Gupta, Praveen Sharma, Narendra Malhotra, Jaideep Malhotra, Uma Pandey, Shivaram Prasad Singh, Kiran Aggarwal, Bhabadev Goswami, Rakesh Aggarwal, Ratna Dua Puri, Anil C. Anand, Ramesh Roop Rai, Vanita Suri, and Radha K. Dhiman
Liver diseases occurring during pregnancy can be serious and can progress rapidly, affecting outcomes for both the mother and fetus. They are a common cause of concern to an obstetrician and an important reason for referral to a hepatologist, gastroenterologist, or physician. Liver diseases during pregnancy can be divided into disorders unique to pregnancy, those coincidental with pregnancy, and preexisting liver diseases exacerbated by pregnancy. A rapid differential diagnosis between liver diseases related or unrelated to pregnancy is required so that specialist and urgent management of these conditions can be carried out. Specific Indian guidelines for the management of these patients are lacking. The Indian National Association for the Study of the Liver (INASL) in association with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) had set up a taskforce for development of consensus guidelines for management of patients with liver diseases during pregnancy, relevant to India. For development of these guidelines, a two-day roundtable meeting was held on 26-27 May 2018 in New Delhi, to discuss, debate, and finalize the consensus statements. Only those statements that were unanimously approved by most members of the taskforce were accepted. The primary objective of this review is to present the consensus statements approved jointly by the INASL and FOGSI for diagnosing and managing pregnant women with liver diseases. This article provides an overview of liver diseases occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and the recommended treatment options.