FIGO guideline on liver disease and pregnancy

Abstract

The number of women entering pregnancy with chronic liver disease is rising. Gestational liver disorders affect 3% of the pregnant population. Both can be associated with significant maternal and fetal morbidity and mortality. European guidance has recently been published to inform management. This FIGO (the International Federation of Gynecology & Obstetrics) guideline aims to use the latest evidence to inform practice relevant to a global population. The immediate past and present chairs of FIGO's Committee on the Impact of Pregnancy on Long-term Health invited the Chair of the European guideline, alongside two trainees with an interest in liver disorders in pregnancy, to develop a guideline relevant to a global audience, thus serving the real-world population and fulfilling FIGO's ambition to enhance their global voice for women's health. Experts in the field with experience in managing liver disorders in pregnancy from a diverse selection of continents helped to develop a guideline. The guideline includes the most common pre-existing and gestational liver disorders. Evidence-based best practice recommendations are summarized in addition to pragmatic recommendations. Printable tables/figures are included in the guideline for ease of use. These include a table of normal ranges of commonly used blood tests, a table outlining safety of investigations, and a table of delivery considerations relevant to a global audience. Figures designed to summarize each section of the guideline and the multidisciplinary approach to managing liver disorders in pregnancy are also included. This guideline incorporates guidance for a global audience aimed at improving the management of women with pre-existing and new liver disease in pregnancy.