⚕️ OBG exam navigator

Liver disorders in pregnancy: decision tree

Tap the flowchart nodes to see diagnosis, danger signs, and the management endpoint. Built for vignette matching: itching, BP/platelets, hypoglycemia, Doppler are the money clues.

Start here

Pregnant patient with jaundice / pruritus / raised LFTs

First ask: crash or stable?

Red flag

Maternal/fetal danger?

Hypoglycemia, renal failure, coagulopathy, severe HTN, platelets low, bad Doppler

Stable lane

No emergency signs?

Then identify ICP vs viral hepatitis vs hyperemesis

BP + platelets

HTN + thrombocytopenia + ↑ LFT

HELLP / severe preeclampsia

Metabolic crash

Jaundice + vomiting/abdominal pain + low sugar

AFLP until proven otherwise

Itching clue

Pruritus + ↑ bile acids

ICP: delivery timing depends on bile acids + GA

Supportive lane

Jaundice + very high transaminases, BP normal

Acute viral hepatitis if no obstetric red flags

Early pregnancy

Severe vomiting in 1st trimester + mild LFT rise

Hyperemesis gravidarum related LFT changes

Fast differentiator

The 5-clue matrix

When options look similar, match the dominant clue, not the biggest lab value.

ICP

Pruritus, ↑ bile acids, mild/moderate LFT rise. Maternal usually okay; fetal risk increases with bile acids. Treat UDCA, surveillance, plan delivery by bile acids/gestational age.

HELLP

Hypertension + platelets low + ↑ AST/ALT ± hemolysis. Give MgSO₄, antihypertensives, corticosteroids if needed, and deliver after stabilization. Bad Doppler/FHR → urgent CS.

AFLP

Hypoglycemia, vomiting, abdominal pain, jaundice, renal dysfunction/coagulopathy/encephalopathy. ICU-style stabilization + urgent delivery. MgSO₄ only if preeclampsia/eclampsia features coexist.

Viral hep

Very high transaminases, jaundice, systemic prodrome; BP and platelets usually normal. Supportive/conservative unless obstetric indication for delivery.

Early pregnancy vomiting, ketonuria/dehydration, mild LFT elevation. Fluids, antiemetics, thiamine before dextrose. No delivery.

Exam one-liners

Itching = ICP. Bile acids decide fetal risk and delivery timing.
BP + platelets low = HELLP. MgSO₄ is the giveaway in options.
Low RBS = AFLP. Think maternal metabolic failure → urgent delivery.
Reversed end-diastolic flow = don’t wait. This pushes to emergency delivery/CS.

Vignette matcher

Liver disorders in pregnancy: decision tree

The 5-clue matrix

Exam one-liners

Tap a stem → see the answer logic

Loading…

Pregnancy Liver Tree