medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2020-4-33-38medalphabet-1451Research ArticleСтатьиНарушения функции печени в первой половине беременности в практике акушера-гинекологаImpaired liver function in first half of pregnancy in practice of obstetrician-gynecologistУспенскаяЮ. Б.UspenskayaYu. B.

д. м. н.

г. Москва

Moscow

КузнецоваИ. В.KuznetsovaI. V.

д. м. н., проф., рук. направления «гинекологическая эндокринология»

г. Москва

Moscow

АНО «НИЦ «Андреевские больницы „НЕБОЛИТ“»РоссияMedical Centre ‘Andreevskie Bolnitsy ― NEBOLIT’Russian FederationНОЧУ ДПО «Высшая медицинская школа»РоссияHigher Medical SchoolRussian Federation20201206202004Современная гинекология3338Copyright © Успенская Ю.Б., Кузнецова И.В., 20202020Успенская Ю.Б., Кузнецова И.В.Uspenskaya Y.B., Kuznetsova I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1451

В статье обсуждается наиболее частая неинфекционная патология печени, осложняющая течение первой половины беременности. Супрафизиологическое повышение уровней половых гормонов и экзогенные гормональные влияния при применении вспомогательных репродуктивных технологий способствуют ранней манифестации внутрипеченочного холестаза беременных и могут быть причиной повреждения печени в первой половине беременности. Неалкогольная жировая болезнь печени во время беременности является самой частой причиной необъяснимого повышения печеночных трансаминаз. Увеличение трансаминаз печени до наступления беременности и на ее ранних сроках ассоциированно с развитием преэклампсии и перинатальных осложнений. К безопасным гепатотропным препаратам в первой половине беременности относятся урсодеоксихолевая кислота, эссенциальные фосфолипиды и растворы низкомолекулярных сахаров.

The article discusses the most common non-infectious liver pathology that complicates the course of the first half of pregnancy. Supraphysiological increase in sex hormone levels and exogenous hormonal effects when using assisted reproductive technologies contribute to the early manifestation of intrahepatic cholestasis in pregnant women and can cause liver damage in the first half of pregnancy. Non-alcoholic fatty liver disease during pregnancy is the most common cause of an unexplained increase in hepatic transaminases. An increase in liver transaminases before pregnancy and in its early stages is associated with the development of preeclampsia and perinatal complications. Safe hepatotropic drugs in the first half of pregnancy include ursodeoxycholic acid, essential phospholipids and solutions of low molecular weight sugars.

внутрипеченочный холестаз беременныхнарушения функции печенипервая половина беременностинеалкогольная жировая болезнь печенинеукротимая рвота беременныхпреэклампсиявспомогательные репродуктивные технологииintrahepatic cholestasis of pregnant womenimpaired liver functionfirst half of pregnancynon-alcoholic fatty liver diseaseindomitable vomiting of pregnant womenpreeclampsiaassisted reproductive technologiesReferencesMikolasevic I, Filipec-Kanizaj T, Jakopcic I, et al. Liver Disease During Pregnancy: A Challenging Clinical Issue. Med Sci Monit. 2018; 24: 4080–4090.Mikolasevic I, Filipec-Kanizaj T, Jakopcic I, et al. Liver Disease During Pregnancy: A Challenging Clinical Issue. Med Sci Monit. 2018; 24: 4080–4090.Westbrook RH, Dusheiko G, Williamson C. Pregnancy and liver disease. J Hepatol. 2016; 64 (4): 933–945.Westbrook RH, Dusheiko G, Williamson C. Pregnancy and liver disease. J Hepatol. 2016; 64 (4): 933–945.Geenes V, Williamson C. Liver disease in pregnancy. 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The authors declare that there are no conflicts of interest present.