Ladislav Turecký
The objective of this paper is to review the physiological changes of laboratory parameters, particularly of liver function tests, during normal pregnancy. The pregnant woman experiences physiological changes to support fetal growth and development. Pregnancy induces physiological and biochemical changes that are often mistaken for signs of liver disease. The physiological changes of the liver are the results of the increment of estrogens and progesterone during pregnancy, insulin resistence during pregnancy and also the hemodynamics changes (hemodilution). Many laboratory parameters appear abnormal during preg- nancy compared with values standardized in a nonpregnant population. However, important markers of liver disease remain within normal limits, including aminotransferases, bilirubin, gamma glutamyltransferase and prothrombine time. Thus, an increase in serum ALT, AST and GMT activities and serum bilirubin and total bile acid concentration during pregnancy may be pathologic and should prompt further evaluation.