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14 - Liver and renal disease

from Section 4 - Metabolic disorders

Published online by Cambridge University Press:  19 October 2009

By
M. J. Paech  and
K. Scott
Edited by
David R. Gambling ,
M. Joanne Douglas  and
Robert S. F. McKay
M. J. Paech
Affiliation:
School of Medicine and Pharmacology, The University of Western Australia, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Subiaco, Western Australia
K. Scott
Affiliation:
Specialist Registrar in Anaesthesia, Oxford Radcliffe Hospitals, NHS Trust, Oxford, UK
David R. Gambling
Affiliation:
University of California, San Diego
M. Joanne Douglas
Affiliation:
University of British Columbia, Vancouver
Robert S. F. McKay
Affiliation:
University of Kansas
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Summary

Liver disease

Effects of pregnancy on the liver

Pregnancy induces anatomic, physiologic, and functional changes in the liver because of an increase in serum estrogen and progesterone. These changes reverse postpartum, but can cause diagnostic difficulties during pregnancy if liver disease is present. For example, spider nevi and palmar erythema are stigmata of liver disease, but may be seen in some pregnant women in response to increased estrogen levels.

In normal pregnancy, liver size does not change significantly so hepatomegaly suggests liver disease. Hepatic blood flow remains unchanged, despite the physiologic increase in blood volume and cardiac output. In fact, the portion of cardiac output delivered to the liver falls by 35%. There is increased splanchnic, portal, and esophageal venous pressure in late pregnancy, and 60% of healthy women will develop esophageal varices that resolve postpartum. Clearance of drugs dependent on hepatic blood flow is reduced because of a larger volume of distribution.

Serum albumin concentration falls by up to 60% secondary to an increase in plasma volume, leading to a fall of total serum protein by 20% in mid-pregnancy. Serum globulins alter slightly, with an increase in α and β fractions, and α-fetoprotein concentration, but a reduction in γ-globulin. There is increased production of fibrinogen and factors VII, VIII, IX, X and von Willebrand factor. Ceruloplasmin and transferrin levels increase, as do several specific binding proteins (e.g. thyroxine, vitamin D, and corticosteroids). There are minor changes in porphyrin metabolism.

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Obstetric Anesthesia and Uncommon Disorders , pp. 249 - 268
Publisher: Cambridge University Press
Print publication year: 2008

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References

Baker, A. L. Liver and biliary tract diseases. In Barron, W. M. & Lindheimer, M. D. (eds)., Medical Disorders During Pregnancy. St. Louis: Mosby, 2000, pp. 330–54.
Benjaminov, F. A. & Heathcote, J.Liver disease in pregnancy. Am. J. Gastroenterol. 2004; 99: 2479–88.Google Scholar
Sookoian, S.Liver disease during pregnancy: acute viral hepatitis. Ann. Hepatol. 2006; 5: 231–6.Google Scholar
Latham, P. S. Liver diseases. In Gleicher, N.et al. (eds.), Principles and Practice of Medical Therapy in Pregnancy. New York: McGraw-Hill Professional, 1998, pp. 1111–225.
Stamm, C. A. & McGregor, J. A. Hepatitis in pregnancy. Ch. 37. In Dildy, G. A., 3rd (ed.), Critical Care Obstetrics. Massachusetts: Blackwell Science, 2004, pp. 333–7.
Scully, L. J. Hepatitis. Ch. 10. Gastrointestinal and liver disease. In Lee, R. V., Rosene-Montella, R., Barbour, L. A., Garner, P. R. & Keely, E. (eds.), Medical Care of the Pregnant Patient. Philadelphia, PA: American College of Physicians-American Society of Internal Medicine, 2000, pp. 563–84.
Airoldi, J. & Berghella, V.Hepatitis C and pregnancy. Obstet. Gynecol. Surv. 2006; 61: 666–72.Google Scholar
Kumar, G. P., Bhat, V. J. & Sowdi, V.Fulminant hepatic failure following halothane anaesthesia. J. Clin. Forensic Med. 2005; 12: 271–3.CrossRefGoogle Scholar
Pascual, Gonzalo V., Gonzalez, Forner A., Salvador, E.et al. Severe acute hepatitis after anesthesia with sevoflurane. Gastroenterol. Hepatol. 2005; 28: 361–2.Google Scholar
Cheung, R. C., McAuley, R. J. & Pollard, J. B.High mortality rate in patients with advanced liver disease independent of exposure to general anesthesia. J. Clin. Anesth. 2005; 17: 172–6.Google Scholar
Nelson-Piercy, C. Hyperemesis gravidarum and total parenteral nutrition. Ch. 10. Gastrointestinal and liver disease. In Lee, R. V., Rosene-Montella, R., Barbour, L. A., Garner, P. R. & Keely, E. (eds.), Medical Care of the Pregnant Patient. Philadelphia, PA: American College of Physicians-American Society of Internal Medicine, 2000, pp. 545–63.
Outlaw, W. M. & Ibdah, J. A.Impaired fatty acid oxidation as a cause of liver disease associated with hyperemesis gravidarum. Med. Hypotheses 2005; 65: 1150–3.Google Scholar
Selitsky, T., Chandra, P. & Schiavello, H. J.Wernicke's encephalopathy with hyperemesis and ketoacidosis. Obstet. Gynecol. 2006; 107: 486–90.CrossRefGoogle Scholar
Chiossi, G., Neri, I., Cavazzuti, M.et al. Hyperemesis gravidarum complicated by Wernicke encephalopathy: background, case report, and review of the literature. Obstet. Gynecol. Surv. 2006; 61: 255–68.Google Scholar
Arrese, M.Cholestasis during pregnancy: rare hepatic diseases unmasked by pregnancy. Ann. Hepatol. 2006; 5: 216–18.Google Scholar
Pauli-Magnus, C. & Meier, P. J.Hepatocellular transporters and cholestasis. J. Clin. Gastroenterol. 2005; 39: S103–S110.Google Scholar
Winton, G. B. & Lewis, C. W.Dermatoses of pregnancy. J. Am. Acad. Dermatol. 1982; 6: 977–98.Google Scholar
Dann, A. T., Kenyon, A. P., Seed, P. T.et al. Glutathione S-transferase and liver function in intrahepatic cholestasis of pregnancy and pruritus gravidarum. Hepatology 2004; 40: 1406–14.Google Scholar
Fisk, N. M. & Storey, G. N.Fetal outcome in obstetric cholestasis. Br. J. Obstet. Gynaecol. 1988; 95: 1137–43.CrossRefGoogle Scholar
Kondrackiene, J., Beuers, U. & Kupcinskas, L.Efficacy and safety of ursodeoxycholic acid versus cholestyramine in intrahepatic cholestasis of pregnancy. Gastroenterology 2005; 129: 894–901.Google Scholar
Riely, C. A. & Bacq, Y.Intrahepatic cholestasis of pregnancy. Clin. Liver Dis. 2004; 8: 167–76.CrossRefGoogle Scholar
Davies, M. H., Silva, da R. C., Jones, S. R.et al. Fetal mortality associated with cholestasis of pregnancy and the potential benefit of therapy with ursodeoxycholic acid. Gut 1995; 37: 580–4.Google Scholar
Kowdley, K. V.Lipids and lipid-activated vitamins in chronic cholestatic diseases. Clin. Liver Dis. 1998; 2: 373–89.CrossRefGoogle Scholar
Yarnell, R. W. & D'Alton, M. E.Epidural hematoma complicating cholestasis of pregnancy. Curr. Opin. Obstet. Gynecol. 1996; 8: 239–42.Google Scholar
Schumann, R. & Hudcova, J.Cholestasis of pregnancy, pruritus and 5-hydroxytryptamine 3 receptor antagonists. Acta Obstet. Gynecol. Scand. 2004; 83: 861–2.Google Scholar
Castro, M. A., Fassett, M. J., Reynolds, T. B.et al. Reversible peripartum liver failure: a new perspective on the diagnosis, treatment and causes of acute fatty liver of pregnancy, based on 28 consecutive cases. Am. J. Obstet. Gynecol. 1999; 181: 389–95.Google Scholar
Doshi, S. & Zucker, S. D.Liver emergencies during pregnancy. Gastroenterol. Clin. N. Am. 2003; 32: 1213–27.Google Scholar
Monga, M. & Katz, A. R.Acute fatty liver in the second trimester. Obstet. Gynecol. 1999; 93: 811–13.Google Scholar
Reyes, H.Acute fatty liver of pregnancy: a cryptic disease threatening mother and child. Clin. Liver Dis. 1999; 3: 69–81.CrossRefGoogle Scholar
Flint Porter, T. Acute fatty liver of pregnancy. Ch. 36. In Dildy, G. A., 3rd (ed.), Critical Care Obstetrics. Massachusetts: Blackwell Science, 2004, pp. 380–5.
Ko, H. & Yoshida, E. M.Acute fatty liver of pregnancy. Can. J. Gastroenterol. 2006; 20: 25–30.Google Scholar
Usta, I. M., Barton, J. R., Amon, E. A., Gonzalez, A. & Sibai, B. M.Acute fatty liver of pregnancy: an experience in the diagnosis and management of fourteen cases. Am. J. Obstet. Gynecol. 1994; 171: 1342–7.Google Scholar
Schoeman, M. N., Batey, R. G. & Wilcken, B.Recurrent acute fatty liver of pregnancy associated with a fatty acid oxidation defect in the offspring. Gastroenterology 1991; 100: 544–8.Google Scholar
Jamerson, P. A.The association between acute fatty liver of pregnancy and fatty acid oxidation disorders. J. O. G. G. N. 2005; 34: 87–92.Google Scholar
Moldenhauer, J. S., O'Brien, J. M., Barton, J. R. & Sibai, B.Acute fatty liver of pregnancy associated with pancreatitis: a life threatening complication. Am. J. Obstet. Gynecol. 2004; 190: 502–5.Google Scholar
Ockner, S. A., Brunt, E. M., Cohn, S. M.et al. Fulminant hepatic failure caused by acute fatty liver of pregnancy treated by orthoptic liver transplantation. Hepatology 1990; 11: 59–64.Google Scholar
Amon, E., Allen, S. R., Petrie, R. H. & Belew, J. E.Acute fatty liver of pregnancy associated with preeclampsia: management of hepatic failure with postpartum liver transplantation. Am. J. Perinatol. 1991; 8: 278–9.CrossRefGoogle Scholar
Antognini, J. F. & Andrews, S.Anaesthesia for caesarean section in a patient with acute fatty liver of pregnancy. Can. J. Anaesth. 1991; 38: 904–7.Google Scholar
Corke, P. J.Anaesthesia for caesarean section in a patient with acute fatty liver of pregnancy. Anaesth. Intensive Care 1995; 23: 215–18.Google Scholar
Thomas, S. D. & Boyd, A. H.Prolonged neuromuscular block associated with acute fatty liver of pregnancy and reduced plasma cholinesterase. Euro. J. Anaesthesiol. 1994; 11: 245–9.Google Scholar
Holzman, R. S., Riley, L. E., Aron, E. & Fetherston, J.Perioperative care of a patient with acute fatty liver of pregnancy. Anesth. Analg. 2001; 92: 1268–70.CrossRefGoogle Scholar
Servin, F., Cockshott, I. D., Farinotti, R.et al. Pharmacokinetics of propofol infusions in patients with cirrhosis. Br. J. Anaesth. 1990; 65: 177–83.CrossRefGoogle Scholar
Gelman, S.General anaesthesia and hepatic circulation. Can. J. Physiol. Pharmacol. 1987; 65: 1762–79.Google Scholar
Schmidt, C. C.Suttner, S. W., Piper, S. N.et al. Comparison of the effects of desflurane and isoflurane anaesthesia on hepatocellular function assessed by alpha glutathione S-transferase. Anaesthesia 1999; 54: 1204–9.Google Scholar
Servin, F. S., Lavaut, E., Kleef, U. & Desmonts, J. M.Repeated doses of rocuronium bromide administered to cirrhotic and control patients receiving isoflurane. Anesthesiology 1996; 84: 1092–100.Google Scholar
Russell, M. A. & Craigo, S. D.Cirrhosis and portal hypertension in pregnancy. Semin. Perinatol. 1998; 22: 156–65.Google Scholar
Lopez-Mendez, E. & Avila-Escobedo, L.Pregnancy and portal hypertension a pathology view of physiologic changes. Ann. Hepatol. 2006; 5: 219–23.Google Scholar
Homburg, R., Bayer, I. & Lurie, B.Bleeding esophageal varices in pregnancy. A report of two cases. J. Reprod. Med. 1988; 33: 784–6.Google Scholar
Duke, J.Pregnancy and cirrhosis: management of hematemesis by Warren shunt during third trimester gestation. Int. J. Obstet. Anesth. 1994; 3: 97–102.Google Scholar
Aranha, G. V. & Greenlee, H. B.Intraabdominal surgery in patients with advanced cirrhosis. Arch. Surg. 1986; 121: 275–7.Google Scholar
Cheng, Y-S.Pregnancy in liver cirrhosis and/or portal hypertension. Am. J. Obstet. Gynecol. 177; 128: 812–22.
Harnett, M. J., Miller, A. D., Hurley, R. J. & Bhavani-Shankar, K.Pregnancy, labour and delivery in a Jehovah's Witness with esophageal varices and thrombocytopenia. Can. J. Anesth. 2000; 47: 1253–5.Google Scholar
Heriot, J. A., Steven, C. M. & Sattin, R. S.Elective forceps delivery and extradural anaesthesia in a primigravida with portal hypertension and oesophageal varices. Br. J. Anaesth. 1996; 76: 325–7.CrossRefGoogle Scholar
Lee, W. M.Pregnancy in patients with chronic liver disease. Gastroenterol. Clin. North Am. 1992; 21: 889–903.Google Scholar
Terkivatan, T., Wilt, J. H. W.Man, R. A.et al. Management of hepatocellular adenoma during pregnancy. Liver 2000; 20: 186–7.Google Scholar
Hill, M. A., Albert, T., Zieske, A.et al. Successful resection of multifocal hepatic adenoma in pregnancy. South Med. J. 1997; 90: 357–61.Google Scholar
Shih, G., Forster, J. & Myers, S.Pregnancy complicated by hepatocellular carcinoma. Anesthesiology 2002; 96(S): P1846.Google Scholar
Bihl, J.The effect of pregnancy on hepatolenticular degeneration. Am. J. Obstet. Gynecol. 1973; 78: 1182–3.Google Scholar
Brewer, G. J.Practical recommendations and new therapies for Wilson's disease. Drugs 1995; 50: 240.Google Scholar
Lao, T. T. H., Chin, R. K. H., Cockram, C. S. & Leung, N. W. Y.Pregnancy in a woman with Wilson's disease treated with zinc. Asia-Oceanic J. Obstet. Gynaecol. 1988; 14: 167–9.Google Scholar
Dawlatly, El A. A., Bakhamees, H. & Seraj, M. A. Anesthetic management for cesarean section in a patient with Wilson's disease. Middle East J. Anesthesiol. 1992; 11: 391–7.Google Scholar
Shimono, N., Ishibashi, H., Ikematsu, H.et al. Fulminant hepatic failure during perinatal period in a pregnant woman with Wilson's disease. Gastroenterol. Jpn. 1991; 26: 69–73.Google Scholar
Scheinburg, I. H. & Steinlieb, I.Pregnancy in penicillamine-treated patients with Wilson's disease. N. Eng. J. Med. 1975; 293: 1300–2.Google Scholar
Khuroo, M. S. & Datta, D. V.Budd-Chiari syndrome following pregnancy. Report of 16 cases with roentgenologic, hemodynamic and histologic studies of the hepatic outflow tract. Am. J. Med. 1980; 8: 113–21.CrossRefGoogle Scholar
Ilan, Y., Oren, R. & Shouval, D.Postpartum Budd-Chiari syndrome with prolonged hypercoaguability state. Am. J. Obstet. Gynecol. 1990; 162: 1164–5.Google Scholar
Riley, L. E. & Tuomala, R. E.Bacillary angiomatosis in a pregnant patient with acquired immunodeficiency syndrome. Obstet. Gynecol. 1992; 79: 818–19.Google Scholar
Omori, H., Asahi, H., Takahashi, M., Kato, K. & Saito, K.Peliosis hepatitis during postpartum period: successful embolization of hepatic artery. J. Gastroenterol. 2004; 39: 168–71.Google Scholar
Slater, L. N, Welch, D. F. & Min, K. W.Rochalimaea henselae causes bacillary angiomatosis and peliosis hepatis. Arch. Intern. Med. 1992; 152: 602–6.Google Scholar
Buchel, E., Steenbergen, W., Nevens, F. & Fevery, J.Improvement of autoimmune hepatitis during pregnancy followed by flare-up after delivery. Am. J. Gastroenterol. 2002; 97: 3160–5.Google Scholar
Manterola, C., Espinoza, R., Munoz, S.et al. Abdominal echinococcosis during pregnancy: clinical aspects and management of a series of cases in Chile. Tropical Doctor 2004; 34: 171–3.Google Scholar
Kain, K. C. & Keystone, J. S.Recurrent hydatid disease during pregnancy. Am. J. Obstet. Gynecol. 1988; 159: 1216–17.Google Scholar
Montes, H., Soetkino, R. & Carr-Locke, D. L.Hydatid disease in pregnancy. Am. J. Gastroenterol. 2002; 97: 1553–5.Google Scholar
Golaszewski, T., Susani, M., Golaszewski, S.et al. A large hydatid cyst of the liver in pregnancy. Arch. Gynecol. Obstet. 1995; 256: 43–7.Google Scholar
Can, D., Oztekin, O., Oztekin, O., Tinar, S. & Sanci, M.Hepatic and splenic hydatid cyst during pregnancy: a case report. Arch. Gynecol. Obstet. 2003; 268: 239–40.Google Scholar
Icely, S. & Chez, R. A.Traumatic liver rupture in pregnancy. Am. J. Obstet. Gynecol. 1999; 180: 1030–1.Google Scholar
Henney, C. P., Lim, A. E., Brummelkamp, W. H.et al. A review of the importance of acute multidisciplinary treatment following spontaneous rupture of the liver capsule during pregnancy. Surg. Gynecol. Obstet. 1983; 156: 593–6.Google Scholar
Rinehart, B. K., Terrone, D. A., Magann, E. F.et al. Preeclampsia-associated hepatic hemorrhage and rupture: mode of management related to maternal and perinatal outcome. Obstet. Gynecol. Surv. 1999; 54: 196–202.Google Scholar
Ralston, S. J. & Schwaitzberg, S. D.Liver hematoma and rupture in pregnancy. Semin. Perinatol. 1998; 22: 141–8.Google Scholar
Tank, P. D., Nadanwar, Y. S. & Mayadeo, N. M.Outcome of pregnancy with severe liver disease. Int. J. Gynecol. Obstet. 2002; 76: 27–31.Google Scholar
Chan, W.-H., Lee, T.-S., Lin, C.-S.et al. Anesthetic management for cesarean section in a pregnant woman with impending liver failure – a case report. Acta Anaesthesiol. Sin. 1999; 37: 141–6.Google Scholar
Friley, M. D. & Douglas, G. Acute cholecystitis in pregnancy and the puerperium. Am. Surg. 1972; 38: 314–15.Google Scholar
Landers, D., Carmona, R., Crombleholme, W. & Lim, R.Acute cholecystitis in pregnancy. Obstet. Gynecol. 1987; 69: 131–3.Google Scholar
McKay, A. J., O'Neill, J. & Imrie, C. W.Pancreatitis, pregnancy and gallstones. Br. J. Obstet. Gynaecol. 1980; 87: 47–50.CrossRefGoogle Scholar
Lu, E. J., Curet, M. J., El-Sayed, M. D. & Kirkwood, K. S. Medical versus surgical management of biliary tract disease in pregnancy. Am. J. Surg. 2004; 188: 755–9.Google Scholar
Hill, L. M., Johnson, C. E. & Lee, R. A.Cholecystectomy in pregnancy. Obstet. Gynecol. 1975; 46: 291–3.Google Scholar
Graham, G., Baxi, L. & Tharakan, T.Laparoscopic cholecystectomy during pregnancy: a case series and review of the literature. Obstet. Gynecol. Surv. 1998; 53: 566–74.Google Scholar
Steinbrook, R. A. & Bhavani-Shankar, K.Hemodynamics during laparoscopic surgery in pregnancy. Anesth. Analg. 2003; 93: 1570–1.CrossRefGoogle Scholar
Goh, S-K., Gull, S. E. & Alexander, G. J. M.Pregnancy in primary biliary cirrhosis complicated by portal hypertension: report of a case and review of the literature. Br. J. Obstet. Gynaecol. 2001; 108: 760–2.CrossRefGoogle Scholar
Patel, P. A., Gold, E., Utts, J.et al. The association between gravity and primary biliary cirrhosis. Ann. Epidemiol. 2002; 12: 264–72.Google Scholar
Nir, A., Sorokin, Y., Abramovici, H. & Theodor, E.Pregnancy and primary biliary cirrhosis. Int. J. Gynaecol. Obstet. 1989; 28: 279–82.Google Scholar
Korkut, E., Kisacik, B., Akcan, Y.et al. Two successive pregnancies after ursodeoxycholic acid therapy in a previously infertile woman with antimitochondrial antibody-negative primary biliary cirrhosis. Fertility Sterility 2005; 83: 761–3.Google Scholar
Janczewska, I., Olsson, R., Hultcrantz, R.et al. Pregnancy in patients with primary sclerosing cholangitis. Liver 1996; 16: 326–30.Google Scholar
Ramin, S. M., Vidaeff, A. C., Yeomanns, E. R. & Gilstrap, L. C. 3rd. Chronic renal disease in pregnancy. Obstet. Gynecol. 2006; 108: 1531–9.CrossRefGoogle Scholar
Holley, J. L., Bernardini, J., Quadri, K. H. M., Greenberg, A. & Laifer, S. A.Pregnancy outcomes in a prospective matched control study of pregnancy and renal disease. Clin. Nephrol. 1996; 45: 77–82.Google Scholar
Malhotra, V. Anaesthesia and the renal and genitourinary systems. In Miller, R. D. (ed.), Anaesthesia, 4th edn. New York: Churchill Livingstone, 1994.
Stoelting, R. K. & Dierdorf, S. F. Renal diseases. Ch. 20. In Anaesthesia and Co-existing disease, 3rd edn. New York: Churchill Livingstone, 1993.
Basta, M. & Sloan, P.Epidural haematoma following epidural catheter placement in a patient with chronic renal failure. Can. J. Anaesth. 1999; 46: 271–3.Google Scholar
Hammouda, G. E., Yahya, R. & Atallah, M. M.Plasma bupivacaine concentrations following epidural administration in kidney transplant recipients. Reg. Anaesth. 1996; 21: 308 –11.Google Scholar
Steer, P. L.Anaesthetic management of a parturient with thrombocytopenia using thromboelastography and sonoclot analysis. Can. J. Anaesth. 1993; 40: 84–5.Google Scholar
Orko, R., Pitkanen, M. & Rosenberg, P. H.Subarachnoid anaesthesia with 0.75% bupivacaine in patients with chronic renal failure. Br. J. Anaesth. 1986; 58: 605–9.CrossRefGoogle Scholar
Kincaid-Smith, P. S. & Fairley, K. F. Renal and urinary tract disorders in pregnancy. Ch. 6. In The Kidney and Hypertension in Pregnancy, 1st edn. New York: Churchill Livingstone, 1994.
Pruett, K. & Faro, S.Pyelonephritis associated with respiratory distress. Obstet. Gynaecol. 1987; 69: 444–6.Google Scholar
Ridgway, L. E., Martin, R. W., Hess, L. W.et al. Acute gestational pyelonephritis: the impact on colloid osmotic pressure, plasma fibronectin, and arterial oxygen saturation. Am. J. Perinatol. 1991; 8: 222–6.CrossRefGoogle Scholar
Meyers, S. J., Lee, R. V. & Munschauer, R. W.Dilatation and nontraumatic rupture of the urinary tract during pregnancy: a review. Obstet. Gynecol. 1985; 66: 809–15.Google Scholar
Packham, D. & Fairley, K. F.Renal biopsy: indications and complications during pregnancy. Br. J. Obstet. Gynaecol. 1987; 94: 935–97.Google Scholar
Alexopoulos, E., Bili, H., Tampakoudis, P.et al. Outcome of pregnancy in women with glomerular disease. Renal Failure 1996; 18: 21–9.Google Scholar
Fervneza, F., Green, A. & Lafayette, R. A.Acute renal failure due to post-infectious glomerulonephritis during pregnancy. Am. J. Kidney Dis. 1997; 29: 273–6.Google Scholar
Cormio, G., Cramarossa, D., Vagno, Di G., Masciandaro, A. & Lovern, G.Successful in pregnancy in a patient with Churg-Strauss syndrome. Eur. J. Obstet. Gynecol. Repro. Biol. 1995; 60: 81–3.Google Scholar
Parnham, A. P. & Thatcher, G. N.Pregnancy and active Wegener's granulomatosis. Aust. N. Z. J. Obstet. Gynaecol. 1996; 36: 361–3.Google Scholar
Dashe, J. S., Ramin, S. M. & Cunningham, F. G.The long-term consequences of thrombotic microangiopathy (thrombotic thrombocytopenic purpura and hemolytic uremic syndrome) in pregnancy. Obstet. Gynecol. 1998; 91: 662–8.Google Scholar
Vasilio, D. M., Maxwell, C., Shah, P. & Sermer, M.Goodpasture syndrome in a pregnant woman. Obstet. Gynecol. 2005; 106: 1196–9.Google Scholar
Wells, S. R., Kuller, J. A. & Thorp, J. M. Jr.Pregnancy in a patient with Goodpasture's syndrome and renal transplantation. Am. J. Perinatol. 1996; 13: 79–80.CrossRefGoogle Scholar
Rizk, D. & Chapman, A. B.Cystic and inherited kidney diseases. Am. J. Kidney Dis. 2003; 42: 1305–17.CrossRefGoogle Scholar
Chapman, A. B., Johnson, A. M. & Gabow, P.Pregnancy outcome and its relationship to progression of renal failure in autosomal dominant polycystic kidney disease. J. Am. Soc. Nephrol. 1994; 5: 1178–85.Google Scholar
King, J. A. & Stamilio, D. M.Maternal and fetal tuberous sclerosis complicating pregnancy: a case report and overview of the literature. Am. J. Perinatol. 2005; 22: 103–8.CrossRefGoogle Scholar
Hudson, B. G., Tryggvason, K., Sundaramoorthy, M. & Neilson, E. G.Alport's syndrome, Goodpasture's syndrome, and type IV collagen. N. Eng. J. Med. 2003; 348: 2543–56.Google Scholar
Sengupta-Giridharan, R., Settatree, R. S. & Jones, A.Complex long term eating disorder, Bartter's syndrome and pregnancy: a rare combination. Aust. N. Z. J. Obstet. Gynaecol. 2003; 43: 384–5.Google Scholar
Deruelle, P., Dufour, P., Magnenant, E., Courouble, N. & Puech, F.Maternal Bartter's syndrome in pregnancy treated by amiloride. Eur. J. Obstet. Gynaecol. Reprod. Biol. 2004; 115: 106–7.Google Scholar
Roelofse, J. A. & Westhuijzen, A. J.Anaesthetic management of a patient with Bartter's syndrome undergoing orthognathic surgery. Anaesthesia Prog. 1997; 44: 71–5.Google Scholar
Nishikawa, T. & Dohi, S.Baroreflex function in a patient with Bartter's syndrome. Can. Anaesth. Soc. J. 1985; 32: 646–50.Google Scholar
Nohira, T., Nakada, T., Akutagawa, O.et al. Pregnancy complicated with Bartter's syndrome: a case report. J. Obstet. Gynaecol. Res. 2001; 27: 267–74.Google Scholar
Bettinelli, A., Tosetto, C., Colussi, G.et al. Electrocardiogram with prolonged QT interval in Gitelman disease. Kidney Int. 2002; 62: 580–4.CrossRefGoogle Scholar
Fowe, T. F., Magee, K. & Cunningham, F. G.Pregnancy and renal tubular acidosis. Am. J. Perinatol. 1999; 16: 189–91.Google Scholar
Holley, L. & Reddy, S. S.Pregnancy in dialysis patients: a review of outcomes, complications, and management. Sem. Dialysis 2003; 16: 384–7.Google Scholar

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  • Liver and renal disease
    • By M. J. Paech, School of Medicine and Pharmacology, The University of Western Australia, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Subiaco, Western Australia, K. Scott, Specialist Registrar in Anaesthesia, Oxford Radcliffe Hospitals, NHS Trust, Oxford, UK
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.015
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  • Liver and renal disease
    • By M. J. Paech, School of Medicine and Pharmacology, The University of Western Australia, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Subiaco, Western Australia, K. Scott, Specialist Registrar in Anaesthesia, Oxford Radcliffe Hospitals, NHS Trust, Oxford, UK
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.015
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Save book to Google Drive

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  • Liver and renal disease
    • By M. J. Paech, School of Medicine and Pharmacology, The University of Western Australia, Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Subiaco, Western Australia, K. Scott, Specialist Registrar in Anaesthesia, Oxford Radcliffe Hospitals, NHS Trust, Oxford, UK
  • Edited by David R. Gambling, University of California, San Diego, M. Joanne Douglas, University of British Columbia, Vancouver, Robert S. F. McKay, University of Kansas
  • Book: Obstetric Anesthesia and Uncommon Disorders
  • Online publication: 19 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544552.015
Available formats
×