How often can you eat beef, chicken or duck liver, and can pregnant women eat Foie gras liver: benefits and harms

The role of the liver during pregnancy

The role of the liver during pregnancy is to perform the following functions:

• accumulation and maintenance of the level of glycogen, vitamins (A, D, B, K, etc.), iron in the body;
• regulation of cholesterol production and excretion;
• detoxification (binding and removal of toxins produced both by the body itself and those coming from outside);
• participation in the work of blood coagulation and anticoagulation systems;
• development of protective factors of the immune system;
• the formation of bile necessary for proper digestion and absorption of food in the small intestine;
• maintaining protein metabolism in the body;
• is the main blood depot in the body (contains about 1 liter);
• converts toxic ammonia (a protein breakdown product) into urea, which is harmless to the body.

In the human body, the liver performs more than 500 important biochemical functions and passes through more than 2000 liters of blood every day.

How to replace liver in the menu for pregnant women

Product interchangeability is a technique that will allow you to eliminate an unsuitable product from your diet.

There are six product groups:

• with a high level of starch (potatoes, cereals, legumes);
• with a low amount of starch (carrots, greens, tomatoes, pumpkin, cucumbers);
• fruits;
• dairy products;
• products of animal origin;
• foods high in fat.

Being in the same group, products contain similar KBJU (calories, proteins, fats, carbohydrates), so they are interchangeable.

Liver is in the group of animal products. The body needs it for healthy hematopoiesis due to the content of iron, copper, zinc, chromium, folic acid, vitamins A, B, B6, B12, C and amino acids. A pregnant woman cannot regularly eat liver dishes , which means they need to be replaced.

A complete liver replacement is beef tongue. It is superior to liver in low cholesterol. 100 grams of this product contains the daily requirement of vitamin B12, and it is the main one in hematopoiesis. A 200-gram serving will saturate the body with protein and iron.

Liver can be replaced with all types of meat. Choose your favorite - veal, lean pork, beef, chicken and turkey (without skin), rabbit. All of them are similar in composition to the liver and the body will not experience a deficiency of nutrients.

How does the liver hurt during pregnancy: symptoms

Pain in the liver area during pregnancy for a long time has a weak aching character. This is due to the fact that there are practically no nerve endings in the tissue of the organ itself. All painful symptoms occur when the liver capsule, which is well innervated, is stretched. The appearance of severe pain means a more severe course of the disease.

Liver damage during pregnancy may also be accompanied by the following symptoms:

• weakness;
• loss of appetite;
• nausea and vomiting (often these conditions are perceived as manifestations of toxicosis and are not associated with liver pathology; some difference is the lack of connection between vomiting and unpleasant odors);
• bitterness in the mouth, especially on an empty stomach;
• abdominal pain that does not have a specific localization;
• yellowing of the skin, sclera of the eyeballs, mucous membranes;
• accumulation of free fluid in the abdomen (pregnant ascites is a difficult to diagnose condition due to an enlarged uterus);
• darkening of urine;
• discoloration of stool.

Contraindications

Many people make the mistake of thinking that this offal is useful in any form; this is not entirely true. After all, the quality of the product, its storage and method of preparation are responsible for its beneficial properties and their safety.

Spoiled chicken or beef liver will never bring you any benefit; on the contrary, it will lead to poisoning and indigestion. The longer an offal is stored, the more toxins accumulate in it.

Women carrying a child under their hearts should eat only fresh liver, boiled, cooked in a slow cooker or steamed.

It is worth noting that if you have high blood cholesterol, kidney problems or an allergy to offal, do not overuse this delicacy. It is best to consult with your doctor to avoid serious consequences and not harm yourself and your baby.

Pain in the liver during pregnancy: causes

The main causes of pain in the hepatic region are pathologies that developed already during gestation. The most common liver diseases during pregnancy include:

• acute fatty liver degeneration;
• development of gestosis with transition to preeclampsia and eclampsia;
• HELLP syndrome;
• cholestasis of pregnancy;
• pathologies of the biliary tract;
• acute liver rupture;
• liver hepatosis.

During pregnancy, especially in the 3rd trimester or when carrying twins, a common situation is when the baby puts pressure on the liver. Due to strong compression of some liver areas, a violation of the outflow of bile may occur. As a result, dilation of the extrahepatic bile ducts is observed, and symptoms of dyspepsia appear. In such situations, you can advise the woman to spend more time lying on her left side. Only childbirth will help you completely get rid of this unpleasant condition.

Liver hemangioma during pregnancy

Liver hemangioma in a pregnant woman is a common benign formation of vascular nature. In most cases, this is a congenital condition that does not require emergency medical intervention. Depending on the size of the tumor, the disease manifests itself in different ways.

Hemangiomas up to 6-7 cm can be detected only during ultrasound diagnostics, without appearing at all before. Larger diameter formations cause symptoms of nausea and vomiting, heaviness in the right hypochondrium, and aching pain. For a long time, the pathology can exist in an inactive state, but a sharp change in hormonal status during pregnancy can trigger a growth spurt.

The danger of hemangioma is the possibility of rupture of the formation during the pushing period of labor. That is why at the end of the third trimester a control ultrasound of the liver is performed. Depending on its size and location, the question of the method of delivery is decided: naturally or through a cesarean section.

Treatment and removal of the neoplasm itself is carried out after childbirth. For this purpose, both standard surgical removal and laser and radiation therapy, as well as cryodestruction, are used.

Increased liver enzymes during pregnancy

The reason why the liver fails to cope during pregnancy is not only mechanical compression of the organ by the uterus, but also an increase in enzymatic load. This is evidenced by an increase in the blood of a pregnant woman in liver enzymes: ALaT, ACaT, GGT, LDH, cholinesterase, prothrombinase and alkaline phosphatase.

An increase in the amount of these enzymes is associated with a toxic effect on the liver parenchyma and its cellular destruction. Depending on the gestational age, some deviations from normal values ​​are allowed. At the same time, it is necessary to carry out dynamic monitoring of changed indicators for the timely initiation of treatment measures.

Fatty liver degeneration in pregnant women

Acute fatty liver degeneration in pregnant women is a serious complication of pregnancy, in which normal liver tissue is replaced by fatty inclusions. As a result, acute liver failure occurs.

Currently, the disease is quite rare, which is explained by careful monitoring of the condition of a pregnant woman throughout the entire gestation period.

The first signs of the disease appear after the 30th week with the following symptoms:

• nausea and frequent painful vomiting;
• diffuse abdominal pain;
• jaundice.

Important! The pathology is more common in primiparas, and the risk of its occurrence increases with multiple pregnancies.

.

Diagnostic criteria for fatty degeneration:

• complete blood count: increase in leukocytes and decrease in platelets;
• Ultrasound: diffuse increase in liver echogenicity;
• histological examination: swollen red blood cells with fatty inclusions of various sizes are revealed.

Maternal mortality in this condition is high: up to 20% of cases. Intrauterine fetal death due to untimely delivery reaches 50%. Lethal outcomes often occur due to the development of disseminated intravascular coagulation syndrome or renal failure.

The main treatment for fatty degeneration is induction of labor or cesarean section. In the early stages and with a mild course of the pathology, hospitalization in a hospital and careful monitoring of the pregnant woman’s condition with symptomatic correction are possible.

Liver enlargement during pregnancy

A slight enlargement of the liver during pregnancy without changing its structure and increasing liver enzymes is not a sign of pathology. This can happen due to increased stress on the circulatory or digestive systems. Occurs more often in the third trimester.

The mechanism of development of this condition includes the appearance of swelling of the liver parenchyma. Due to edema, metabolic processes in the body are disrupted, as well as oxygen starvation of the liver. In this case, supportive corrective therapy is carried out until birth.

Changes in the structure of liver tissue or liver enzymes, the appearance of dyspeptic symptoms along with liver enlargement, may indicate the development of:

• viral damage (hepatitis B, C, mononucleosis);
• severe gestosis;
• amyloidosis;
• steatosis.

Liver hepatosis in pregnant women

Liver hepatosis is a collective name that includes any disorder of metabolic processes in hepatocytes (liver cells). The most common condition that occurs during pregnancy is cholestatic hepatosis. Occurs after 25-26 weeks of gestation and occurs in approximately 1% of all pregnancies.

The course and manifestations of the disease are similar to acute fatty liver disease. Symptoms of cholestatic hepatosis of the liver during pregnancy:

• weakness and lethargy;
• dyspeptic disorders: loss of appetite, nausea, vomiting, bitterness in the mouth;
• widespread itching throughout the body;
• yellowness of the skin;
• discoloration of stool.

Treatment consists of symptomatic supportive therapy. In 80% of cases, premature delivery is performed to prevent the development of complications. In the postpartum period, hepatosis can cause massive bleeding, since the production of blood coagulation factors is disrupted in the liver.

Symptoms

Symptoms of liver problems in pregnant women with intrahepatic cholestasis are severe itching on the palms and soles.
Some women report itching all over their body. In 20% of patients, yellowing of the whites of the eyes is also observed.

The main symptoms of hepatitis are weakness, nausea, vomiting, and a slight increase in temperature for quite a long time. This also includes the yellow whites of the eyes and skin.

With cholestatic hepatosis, light stool, dark urine, yellow skin, bitter taste in the mouth, problems with stool, pain in the right side are observed.

If a woman has fatty hepatosis, she experiences a constant feeling of fatigue, her appetite disappears, and weight loss occurs.

There may be problems with concentration and memory.

Diagnosis of liver diseases during pregnancy

The main diagnostic measures when studying the condition and function of the liver during pregnancy are:

• general blood test (especially important indicators are leukocytes and platelets);
• general urine test (color is important);
• stool analysis (color is important);
• coagulogram (to determine the activity of production of coagulation factors);
• biochemical blood test (total protein and fractions, bilirubin and fractions, liver enzymes, urea, creatinine, electrolytes);
• Ultrasound (pays attention to size, structure, presence of pathological inclusions, etc.).

Ultrasound of the liver during pregnancy: indications and interpretation

Pregnant women often ask the question: is it possible to do an ultrasound of the liver during pregnancy? The answer is simple: it is possible, and if indicated, it is even necessary. This procedure does not pose any danger to the fetus. The direction of the ultrasound does not coincide with the location of the uterus, and therefore the expectant mother does not have to worry about frequent ultrasound examinations.

An ultrasound of the liver is not required for a pregnant woman in the absence of any complaints on her part, as well as good tests during pregnancy. However, if symptoms of liver damage or elevated liver enzymes occur, ultrasound examination is indicated at any stage of gestation.

Normal liver ultrasound readings during pregnancy:

Any liver changes or abnormalities should only be considered in conjunction with laboratory blood tests.

Diffuse liver changes during pregnancy

Diffuse changes are the most common liver pathology during pregnancy. In most cases, they do not pose a threat to the life and health of the mother and fetus and gradually disappear after childbirth. This condition is characteristic of excessive growth of stroma in the parenchyma.

In itself, it is not a pathology and does not require drug correction. However, in combination with additional signs of liver damage, it is one of the symptoms of various diseases of this organ.

Liver tests during pregnancy

To determine liver function, a pregnant woman is prescribed a biochemical blood test for liver enzymes, which includes the following laboratory parameters:

1. Indicator indicators
. Necessary for determining the cellular destruction of an organ, showing the degree of damage. These include:

• ASAT (aspartate aminotransferase) – up to 31 Udl ​​(during toxicosis, a slight increase is permissible);
• ALT (alanine aminotransferase) - up to 31 Udl ​​(during toxicosis, a slight increase is acceptable);
• GGT (gammaglutamyltransferase) – up to 36 IU (possible increase in the second trimester);
• LDH (lactate dehydrogenase) – from 136 to 234 IU (a slight increase in the 3rd trimester is considered normal).

2. Secretory indicators . Show the degree of liver activity in the work of the blood anticoagulation system. These include:

• cholinesterase – 5300-12900 U/l;
• prothrombinase – 80-120% – 1st trimester; 80-125% - 2nd trimester; 80-130 – 3rd trimester;

3. Excretory indicator. Determines the functioning of the biliary system:

• alkaline phosphatase - up to 150 IU (a slight increase is acceptable after the 20th week of gestation).

Also important indicators of liver function in a biochemical blood test are:

• total bilirubin – 3.4 – 21.6 mmoll;
• direct bilirubin - 0 - 7.9 mmol;
• indirect bilirubin – 3.4 – 13.7 mmoll;
• total protein – 63 – 83 hl;
• albumin – 1st trimester – 32 – 50 hl; 2nd trimester – 28 – 55 hl; 3 trimester – 25 – 66 hl;
• globulin – 28 – 112 hl (in the 3rd trimester it is allowed to significantly exceed the norm);
• cholesterol – 6.16 – 13.72 hl (indicator may vary depending on the age of the pregnant woman)
• urea – 2.5 – 7.1 mmol (in the third trimester up to 6.3).

Important! Donating blood for analysis must be carried out in the first half of the day and strictly on an empty stomach.

Poor liver parameters during pregnancy must be dynamically monitored. A diagnosis is made only after repeated tests.

Liver treatment during pregnancy

Individual treatment protocols have been developed for each liver disease. In most cases, liver treatment for pregnant women is carried out only as a symptomatic effect, which is aimed at maintaining the function of the organ.

Some diseases (hemangioma, diffuse changes) do not require drug correction and are simply observed by the attending physician. The main liver therapy is carried out after pregnancy. More serious conditions, such as acute fatty degeneration or cholestatic hepatosis, require the mandatory use of special drugs for the liver during pregnancy.

Treatment of the liver during pregnancy in the 1st trimester is necessary only in cases where damage to the organ occurred before conception. In such cases, the doctor decides on the possibility of carrying a pregnancy against the background of an existing pathology and determines the risks of complications during its course.

When asked what to do if your liver hurts during pregnancy, there is only one correct solution: consult a specialist. Complications arising from severe liver pathologies can lead to the most serious consequences: death of the mother or fetus. Therefore, if there are liver problems during pregnancy, a woman must follow the recommendations of her doctor. This will help ensure a favorable pregnancy and the birth of a healthy baby.

Anastasia Vinarskaya, obstetrician-gynecologist, especially for Mirmam.pro

Causes

Most liver diseases appear due to changes in the female body. For example, intrahepatic cholestasis is formed as a result of hormonal fluctuations. Sometimes it is aggravated by hereditary predisposition.

Doctors note that this disease is typical for women carrying multiple pregnancies.

In addition, liver problems develop due to increased intra-abdominal pressure, displacement of internal organs, disruption of the biliary tract, and changes in the chemical composition of bile.

When is it time to see a doctor?

The main symptom of liver pathology that attracts attention is pain in the right hypochondrium. The spectrum of pain is varied, depending on the location of the pathology. But in any case, frequent painful sensations in the right hypochondrium are a reason to suspect inflammatory diseases in the liver tissue. You should also pay attention to the appearance of itching and yellowness of the skin. Spider veins and increased capillary fragility may appear. The liver synthesizes protein, including for the blood coagulation system. The presence of hematomas and bleeding is one of the important signs of decreased liver function. If such symptoms appear, you should immediately contact an antenatal clinic.

All liver diseases can be divided into the following groups:

1. Liver diseases associated with pregnancy;
2. Liver diseases not associated with pregnancy.

Diseases that are not associated with pregnancy are usually chronic in nature and their symptoms may be familiar to a woman even before conception. In this case, diagnosing the disease is easier and faster. With medical and medication support, there is every chance of giving birth to a healthy child. But, nevertheless, knowing about the presence of the disease, it is necessary to strictly follow the recommendations of doctors, systematically monitor the condition of the liver using biochemical blood tests and follow a dietary diet.

Diagnostics

Laboratory changes in HELLP syndrome develop faster than clinical manifestations. One of the main signs is the development of hemolysis of red blood cells in the blood smear. The following laboratory changes are also characteristic:

• decreased ESR;
• ALT and AST increased to 500 units;
• increased alkaline phosphatase;
• increase in bilirubin;
• decrease in the amount of protein in the blood, platelets, glucose;
• prothrombin time is increased.

Ultrasound of the liver reveals areas with reduced echogenicity, which are the result of necrosis and hemorrhage.

Intrahepatic cholestasis is characterized by changes in laboratory parameters. Alkaline phosphatase, cholesterol, and cholic acid increase. On ultrasound, the size of the liver was not changed. There may be an enlargement of the gallbladder.

Fatty hepatosis in laboratory studies is characterized by an increase in the number of leukocytes, the appearance of red blood cells with nuclei, segmented red blood cells, and signs of disseminated vascular coagulation. The prothrombin time and the number of fibrinogen degradation products increase. Liver biopsy reveals fatty hepatocytes.

What happens to the body during pregnancy?

Quite often, women during pregnancy complain of pain in the liver area. Due to fetal growth and increased intra-abdominal pressure, organs located in the abdominal cavity are compressed by the enlarged uterus. This can lead to disruption of their function. The liver, in addition to mechanical pressure, has a heavy workload. During pregnancy, the liver performs its functions not only for the mother’s body, but also for the growing fetus. At this time, all the hidden resources of the organ are mobilized, its intensity and productivity increase, and metabolic mechanisms improve. When carrying a child, the metabolic processes in a woman’s body change and the liver has to do its work in completely new conditions and adapt to the changes.

Since the liver is an important digestive gland, it is necessary to monitor its function throughout pregnancy. After all, normal mother’s digestion is the key to the development of a healthy child. Bile, produced by the liver, is actively involved in digestion, breaking down fats and facilitating their absorption. It should be noted that bile can stimulate intestinal motility and the secretion of pancreatic juice, thereby preventing stagnation of food and the development of constipation in pregnant women.

The liver also neutralizes harmful substances, biologically active compounds and waste products not only of the mother, but also of the developing child. Around the beginning of the second trimester, the content of sex hormones in a woman’s blood, necessary for the normal course of pregnancy, increases significantly and the load on the liver increases, since it is in this organ that biologically active substances are deactivated.

If pregnancy is normal and there is no history of liver pathology, a slight decrease in the function of the organ and a slight increase in its size due to the increased load are allowed. But neither the tissue nor the structure of the liver should be changed.

Timely medical care contributes to the disappearance of symptoms after childbirth and normalization of organ function. It is very important to consult a doctor when symptoms appear. It is possible that a pregnant woman will need to be treated in a hospital setting, since liver dysfunction is a prerequisite for the development of gestosis and difficulty in bearing a child.

What signs are accompanied by cholecystitis?

Pain in the liver area can occur with cholecystitis. Factors that provoke the occurrence of an inflammatory process in the bladder are given below:

1. Infectious diseases;
2. Unbalanced diet;
3. Prolonged stress;
4. Low physical activity;
5. Congenital deformities of the biliary tract;
6. Injuries;
7. Tumors of the digestive organs;
8. Deterioration of metabolism;
9. Increased glucose levels in the body.

The characteristic symptoms of acute cholecystitis during pregnancy should be highlighted:

• The occurrence of paroxysmal pain in the area of ​​the gallbladder. Unpleasant sensations often radiate to areas of the body such as the shoulder or shoulder blade;
• The appearance of attacks of nausea;
• Vomit;
• The appearance of skin itching.

During an attack of acute cholecystitis, sharp pain often occurs under the right rib. The expectant mother often vomits. Bile impurities are found in the vomit. Body temperature during inflammation in the gallbladder can reach 38 degrees.

Chronic cholecystitis is characterized by the following symptoms:

1. Discomfort in the right hypochondrium;
2. A feeling of heaviness in the area of ​​the digestive organs. As is correct, it occurs after eating;
3. Belching;
4. Nausea;
5. The appearance of an unpleasant taste in the mouth.

In some situations, chronic cholecystitis in pregnant women is asymptomatic.

In severe forms of chronic cholecystitis, the condition of the fetus worsens significantly. Due to constant vomiting, useful substances are removed from the mother's body. The unborn child does not receive the minerals and vitamins he needs in sufficient quantities. Nutrient deficiency often leads to intrauterine growth retardation.