Abstract:
Introduction: Expressed cytolytic syndrome in quarter 2-3 o f pregnancy may create great
difficulties in diagnostic and therapeutic approaches. Potential prognostic risk increases the
importance of detailed differential diagnosis and adequate therapeutic conduct.
Material and methods: A case report of acute hepatitis C, with onset in the 22nd week of
gestation, that put issues of early diagnostic and management. 34 years old woman has been addressed
to the SCR, Chisinau with the diagnosis of reference: intrahepatic cholestasis of pregnancy; chronic
hepatitis of unidentified etiology, high activity. Fourth pregnancy with normal obstetrical history.
Results: The only accuse was persistent cutaneous pruritus which disrupts sleep. Gravidarum
dermatitis was suspected before the hospitalization in the department of infectious diseases. In the
referral: ALT - 526.8 U/l, AST - 482.7 U/l, total bilirubin - 30,5 mmol/1, conjugated bilirubin -
23.2 mmol/1, the viral hepatitis markers was negative. The patient was hospitalized in the
hepatology department, where ALT was 426.7 U/l, AST - 307.1 U /l, total bilirubin- 24.4 mmol/1,
conjugated bilirubin - 15.1 mmol/1, biliar acids - 6.2 mmol/1, aldolase - 12 U/l. Cutaneous pruritus
intensity decreased after beginning the treatment with ursodeoxycholic acid. Acute hepatitis C was
established after repeated tests for viral hepatitis markers.
Conclusion: Etiology of liver disease in pregnancy may present diagnostic difficulties. It’s
very important to know the features of possible liver pathologies caused by pregnancy and to
remember about the possible association with pregnancy independent conditions.
