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Premature Birth Causes | Acute Liver Failure During Pregnancy

Acute Liver Failure During Pregnancy Obstetric Cholestasis

The liver is the largest organ in the body and among the most important in maintaining proper bodily functions. However, just like every other body organ, the liver depends on hormones to control its functions, and disruptions to the normal balance can lead to dysfunctions. During pregnancy, hormones have to adjust to accommodate the child in the womb, and normally these wouldn’t affect the liver. Sometimes, though, it can lead to liver dysfunctions which occur in around 3% to 10% of all pregnancies. There are 2 conditions that can affect the liver during pregnancy: Obstetric cholestasis and Acute fatty liver pregnancy.

Obstetric Cholestasis Symptoms During Pregnancy

Also called intrahepatic cholestasis of pregnancy (ICP), this is a rare condition that occurs during the late stages of pregnancy due to hormones estrogen and progesterone imbalance. Symptoms of obstetric cholestasis include itchiness, which is sometimes intense and very uncomfortable, primarily in the palms of your hands and soles of your feet.

Your liver produces bile, which helps in the breakdown of fats, after which it flows down to the intestines to be removed from the body. As a result of because of hormonal imbalance, less bile flows into the intestines and starts to build up in your body and with time it begins to affect your liver.

Besides the itching, however severe, the condition does not pose any danger to the mother, and the symptoms disappear soon after birth. On the other hand, obstetric cholestasis often leads to premature birth, either due to premature labour or under the advice of your doctor for the good of the child. Besides, it can also cause your child to pass meconium (their first poo) while still in the womb, which can lead to breathing problems. This is one of the reasons a doctor may recommend an early birth. (Read more: Abortion Options in Brooklyn)

Liver Failure Treatment: How to Avoid Premature Birth

There is, unfortunately, no cure for obstetric cholestasis, and you will have to cope with it until birth. Several creams and antihistamine tablets are available, though, and those can make your life a bit easier.
Vitamin K substitutes will also be prescribed because OC reduces uptake of vitamin K, reducing the blood clotting rate. Without these substitutes, there may be a chance of excessive bleeding during delivery, but improved vitamin K count will improve the blood clotting rate.

Acute Fatty Liver of Pregnancy (AFLP)

Rare condition just like obstetric cholestasis, occurring in 1 out of 13,000 pregnancies, AFLP is a more serious condition affecting the liver during pregnancy. Early signs of the disease include fatigue, vomiting, nausea and abdominal pain, and these occur in the third trimester. As the disease continues to develop, jaundice may be noted through the yellowing of the skin.
It is caused by a mitochondrial dysfunction in the oxidation of fatty acids. This leads to an accumulation of hepatocytes and infiltration of fatty acids causing microvesicular steatosis in the liver.
Effects of AFLP
It can cause a total liver failure or even encephalopathy which is noted by mental confusion and eventually coma.
Dealing with AFLP
About 10 – 20% of mothers with AFLP will die, and the best solution is to identify the condition during the early stages. Sometimes, an emergency delivery (premature birth) may be recommended, and the liver may recover soon afterwards.

Medical Emergency: Shoulder Dystocia Management

Medical Emergency: Shoulder Dystocia Management

Shoulder dystocia is an emergency condition which occurs during the second stage of labor. This medical emergency occurs due to the fact that one of the baby’s shoulders becomes stuck, once the baby’s head has been born. One or both of the baby’s shoulders can get stuck behind the pelvic bones of the mother.

Medical Emergency: What Is Shoulder Dystocia?

There are different factors contributing to this emergency, like:

  • Macrosomia – having a big baby
  • Small pelvis
  • Baby’s position during birth, etc.

Luckily it is a rare emergency in vaginal deliveries (Read also; Common Labor Complications).

Once shoulder dystocia occurs, the baby needs to be born quickly in order for him/her to continue to get enough oxygen. While the baby is stuck into this position in the birth canal, the umbilical cord that supplies the baby with oxygen, blood and necessary ingredients is squashed, which will make your baby suffer for oxygen and blood very quickly.

As mentioned, luckily shoulder dystocia is a rare complication during vaginal childbirth. It is also a complication that can’t be predicted.

Risk Factors for Shoulder Dystocia

Some factors can increase the odds of shoulder dystocia, like: delivering a big baby, usually a baby weighing more than 4 kg, if the pregnant woman has already had shoulder dystocia problems in the previous childbirths, if the pregnant woman is overweight, is there is need for assisted birth using forceps or ventouse, if the labor is induced, if the pregnant women suffers from gestational diabetes, etc.

However, regardless of the above mentioned risk factors for shoulder dystocia, this medical emergency can occur also in women without any of the above mentioned risk factors.

Shoulder Dystocia Management with

The only symptom of shoulder dystocia is a stalled delivery after the baby’s head has been born. This medical emergency should be recognized on time by the doctor and midwives in order to help you deliver the baby as quick as possible.

Shoulder dystocia is something that can’t be prevented, due to the fact that is an unpredictable medical emergency. However, if one or more of the possible risk factors are present, considering other birth methods like C-section delivery are a vise option, comparing to vaginal delivery.

What Are the Complications of Shoulder Dystocia?

If the medical emergency is recognized on time from the doctors and midwifes, usually the baby is born without any consequences. Complications for the baby include: lack of oxygen, fracture of the collarbone or arm, injury of the brachial plexus or even paralysis.

Complications for the mother include: hemorrhaging, bruising or tearing of the genital area, bruising of the bladder, uterine rupture, etc.

What are the options once Shoulder dystocia occurs?

Once shoulder dystocia occurs, your doctor will decide which of the following options for delivering the baby is the safest for you:

  • Manipulated vaginal delivery – your doctor could use a variety of maneuvers which can help your baby be born
  • C-section – if the maneuvers don’t work


Tips for Childbirth Progress: Understanding Labor Stage

Tips for Childbirth Progress: Understanding Labor Stage

The period of labor and childbirth are one of the most difficult but also the most excited moments in a female’s life. Understanding the labor stage will help you be better prepared for this period. For the first time mom’s it is hard to know when the labor begins. In some cases it all occurs very quickly.

How Long Does Labor Last

Every pregnancy is different and there is a wide variation in the length of labor. For women who are giving birth for the first time, labor often takes 10 – 20 hours. However, for some women it can last much longer. On the other hand, for some women the labor period is much shorter. The labor period is more quickly for women who have already given birth vaginally in the past.

Most women give birth between the 37 and 42 week of pregnancy. However there is no way to pinpoint when the labor will begin and the child will be born.

The process of labor and childbirth is divided into three stages.

Early Labor Signs and Symptoms

During the first labor stage the contractions begin. These contractions intend to be much longer, stronger and closer together as labor progresses. During this phase, contractions usually last between 30 and 60 seconds; they generally start 20 minutes apart and move to about 5 minutes apart. Eventually these contractions will last 40-60 seconds and they will be coming often, every five minutes. Contractions cause progressive changes in the cervix. This stage ends when the cervix is fully dilated. This stage is divided into early labor and active labor (Learn more: What Causes Water to Break). Early labor is characterized by a gradually thinning and opening of the cervix, while the active labor is characterized by a rapid dilatation of the cervix, which ends with a total cervix dilatation. (The cervix should be dilated 10 cm). The last part of active labor, when the cervix dilates from 8 to 10 centimeters, is called the transition phase. By the time the cervix is fully dilated the baby has usually descended and entered the birth canal.

Second Stage Labor Management

After the cervix is totally dilated the second stage of labor beings. This labor stage ends when the baby is delivered. It is often referred as the pushing stage. It lasts about an average of one-half hour to two hours in first-time moms. In subsequent births, it may last anywhere from a few minutes to two hours.

Third Labor Stage: Placental Separation

The third labor stage of labor is considered the stage after the baby is born and until the placenta is delivered. Couple of minutes after giving birth, the uterus begins to contract again and the placenta gets separated from the uterine wall. On average, the third stage takes about five to ten minutes.

Keep in mind that labor is different for every woman. Labor and delivery are also different for each of the pregnancies.

Sometimes labor can be induced (Read also: Common Labor Complications). The decision to induce labor is often made by the doctor when the woman has past her due date or when there are health problems regarding the baby or the mother.


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This website contains general information about medical conditions and treatments. The information is not medical advice.

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