Does pregnancy affect the Liver? Are there changes in Liver function?
Pregnancy has no effect on a normal liver. There are no significant changes in liver function. However, certain markers of liver function may alter slightly during normal pregnancy. This small change does not indicate liver disease. For example, blood levels of the protein albumin will decrease during pregnancy because of dilution of the expectant mother's blood with additional retention of free water. In addition, the blood test for alkaline phosphatase will increase during normal pregnancy because of production of this marker by a normal placenta. This should not be considered as an indicator of bad liver function.

Should pregnant women be tested for hepatitis B & C?
It is now recommended that all pregnant women be tested during the last two to three months of pregnancy for the presence of the hepatitis B virus. Babies born to women carrying the hepatitis B virus are at high risk of contracting hepatitis B immediately after delivery. Preventive measures given to babies include vaccination against the hepatitis B virus right after birth and administration of a special gamma globulin preparation for immediate protection. These measures prevent 90-95% of transmission. Similarly transmission of hepatitis C is also possible by the same route. Unfortunately there is no sure way of preventing the transmission or treating the virus in the baby.

Can women who are infected with viral hepatitis become pregnant?
Yes, especially if their liver has not been seriously damaged. However the expectant mother should be aware of all the consequences and take adequate measures where possible.

Should babies be vaccinated for hepatitis B?
If the mother does not carry the hepatitis B virus but other family members do, then babies and young children should probably be vaccinated as early as possible. It is now recommended that all children ultimately receive vaccination against hepatitis B as well, since it is a preventive infection that may occur at any time.

Can mother who are infected with hepatitis B or C breast-feed their babies?
Mothers who are infected with hepatitis B may breast - feed their babies, especially if the babies have received appropriate vaccination. It is not known whether the hepatitis C virus can be transmitted in breast milk. This, however, seems to be a low risk.

Can a nursing mother take interferon, the drug for hepatitis B or C, or will it harm the baby?
A nursing mother may take interferon for hepatitis B or hepatitis C. It is not known, however, whether the interferon will have any effects on the nursing baby. Because interferon treatment of chronic hepatitis B or hepatitis C is elective, it would probably be wise to give mother interferon either before she becomes pregnant or after she has finished nursing.

Why do some pregnant women experience itching and jaundice?
During pregnancy some women experience the onset of itching (puritis) and jaundice, usually related to an impaired bile metabolism and flow. It arises because of changes in the liver's ability to handle chemicals called bile acid and bilirubin, and to make bile, probably from the effects of large doses of the hormone estrogen (which normally increases during pregnancy). Certain women have an inherited susceptibility to these effects of estrogen, women who have had impaired bile flow in pregnancy may develop a similar disorder if they take oral contraceptives. For the mother the disorder is mild, although the itching can be very bothersome. In severe cases the fetus may become distressed and there is a risk of premature delivery and a low but increased risk of early fetal death or stillbirths. In general the disease is moderate to mild, and neither the mother nor the baby suffer any lasting consequences.

Can women become pregnant after undergoing a liver transplant?
Women can become pregnant and go on to deliver a normal baby after undergoing a successful liver transplant. However it is normally recommended to wait for at least two years after the liver transplant. The immunosuppressive medications given during pregnancy is not known to produce any adverse effect in the baby, though there are no long-term studies published. The transmission of viral hepatitis to the new born baby is an issue that should be given due concern.

Can someone with liver cirrhosis become pregnant?
It is much more difficult for women with liver cirrhosis to become pregnant because of markedly decreased fertility. However If they do become pregnant, they may give birth to a healthy baby. The mother, may experience any of the known complications of liver failure during pregnancy, and the baby is at higher risk of premature delivery, spontaneous abortion, miscarriage, and stillbirth. Those children who are born however, are generally remain healthy.

Is it safe for a pregnant woman to drink moderate amount of alcohol?
For any woman with liver disease, it makes sense to avoid taking in substances such as alcohol that are known to cause liver toxicity. In addition alcohol could damage the unborn child. Moderate consumption (one to two drinks) probably does not affect the liver of an otherwise normal pregnant woman, but even moderate doses may cause damage to the unborn child.