GynecologyGynecologyГинекология2079-56962079-5831Consilium Medicum28457ArticlesСтатьиResearch ArticleDifferential diagnosis of subclinical isolated increase of hepatic transaminases in the second half of pregnancyДифференциальная диагностика субклинического изолированного повышения трансаминаз печени во второй половине беременностиUspenskayaYu BУспенскаяЮлия Борисовна

канд. мед. наук, вед. науч. сотр. научно-исследовательского отд. женского здоровья НИЦ ГБОУ ВПО Первый МГМУ им. И.М.Сеченова

jusp@mail.ruKuznetsovaI VКузнецоваИрина Всеволодовна

д-р мед. наук, проф., гл. науч. сотр. научно-исследовательского отд. женского здоровья НИЦ ГБОУ ВПО Первый МГМУ им. И.М.Сеченова

I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian FederationГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России15102015175VOL 17, NO5 (2015)ТОМ 17, №5 (2015)141809042020Copyright ©; 2015, Consilium MedicumCopyright ©; 2015, ООО "Консилиум Медикум"2015Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://gynecology.orscience.ru/2079-5831/article/view/28457

The review examines the problem of increase of liver transaminases in the second half of pregnancy. ALT and AST reflect processes of hepatocyte injury, but are not specific for the diagnosis of a particular disease of the liver. However, determining the cause of changes of liver samples in a short time in pregnant women is extremely important because of the significant differences in prognosis for the mother and the fetus, and the tactics of treatment and management of patients. Authorspresent algorithm of differential diagnosis of obstetric and non-obstetric causes of enlarged alanine aminotransferase and aspartate aminotransferase in the later stages of gestation.

В обзоре рассматривается проблема повышения трансаминаз печени во второй половине беременности. Показатели печеночных аспартатаминотрансферазы (АСТ) и аланинаминотрансферазы (АЛТ) отражают процессы повреждения гепатоцитов, но не являются специфичными для диагностики конкретного заболевания печени. Вместе с тем определение причины изменения показателей печеночных проб в короткие сроки у беременных чрезвычайно важно из-за существенных различий как в прогнозе для матери и плода, так и в тактике лечения и ведения пациенток. Представлен алгоритм дифференциальной диагностики акушерских и неакушерских причин повышения АЛТ и АСТ на поздних сроках гестации.

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