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Disease ymptoms

IntrahepaticCholestasis of

Pregnancy

Herpes Gestationis

PUPPP

 AFLP

• Unknwon etiology • Begins 3rd Trimester and Worsens• More severe on extremities• Associated w/ OCPs (hormonal etiology?)

• Clinical Dx — AST/ALT levels WNL• No hepatic sequelae in mother•  Jaundice or! bile acids associated w/ fetal problems

• Cholestyramine or ursodeoxycholic acid

• No relationship to HSV • Begins 2nd Trimester

•  Autoimmune? (IgG"

 BM"

 Classical Pathway)• Def Dx " Immuno-F of specimens

• Neonatal lesions will resolve

• Intense pruritus " patches of cutaneous erythema " small vesicles & tense bullae

• Limbs > Trunk • IUGR and stillbirth association•  Tx " oral corticosteroids

• Lesions: abdomen " things " butt/arms

• Erythematous urticarial plaques & small papulessurrounded by pale halo

• No adverse fetal problems

• Immuno-F negative for IgG and complement• Histo " normal epidermis & lymphocytes/histiocytres" 

dermal edema

• Microvascular steatosis of liver 2/2 mitochondrialdysfunction

• Rare, but very serious condition

• RUQ pain, N/V, ARF, Hypoglycemia, Coagulopathy, Liverfailure

• Deliver is only Tx

  Abnormal LFTs in Pregnancy

Disease Characteristics

 AFLP • N/V, icteric, hypoglycemia , coagulopathy 

Preeclampsia • LFTs 100-300 IU/L range, HTN, Proteinuria (>300mg/24hr)

HELLP • Hemolysis, LFTs can be up to 1000 IU/L, Platelets

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 aternal & Neonatal Complications of Diabetes in Pregnancy 

Neonatal aternal

 All diabetics(Gest & Pre-gest)

• Birth injury • NICU admission• Hypoglycemia• Hyperbilirubinemia

• Macrosomia• Polyhydraminos• Long term " 

Childhoodobesity 

• Increasedrisk for C/S

• Increasedmaternallaceration &injury 

• Preeclampsia• Long term " 

Metabolic syndrome& overt diabetes

Pre-Gestional• Congenital

anomalies• IUGR  

• Miscarriage• Prematurity 

• Worseningproliferativeretinopathy 

• Worseningnephropathy (ifmoderate/severepreexisting)