Treatment of elevated transaminases in pregnant women. Differential diagnosis of subclinical isolated enhancement of liver transamamine in the second half of pregnancy

What is Alt and Ast, the norm in pregnant women of these parameters is how to identify their level? So called marker enzymes for the liver, myocardium, lungs, kidneys, pancreas. If you decipher the abbreviations, the following is alanine-one-resferase and aspartataminotransferase. In the presence of these transaminases in the blood, the work of the organs is disturbed, due to the fact that the cells are destroyed. The increase in these enzymes indicates the development of complex disease. When considering the results of blood test results, it turns out where the focus is located.

Norm in pregnant women

When entering the child, the woman's body is experiencing various changes - starting with a hormonal background and ending with all organ systems. Therefore, the indicators of any tests may differ from the child being conceived. What is the level of Alt and Ast in the norm in pregnant women? In healthy pregnant women, the Alt indicator will be considered normal with data in the area of \u200b\u200b31 units / ml.

This enzyme can be detected in the following organs:

liver;
kidneys;
muscles of the heart;
spleen;
pancreas;
lungs.

If there is a violation in the process of functioning of these cells, they massively fall into the blood.

Such a process indicates development:

hepatitis A;
hepatosis;
liver damage;
inflammatory process in the pancreas;
heart or kidney diseases.

In pregnant women, an increase in the level of Alt in the third trimester may occur. This contributes to the emergence of late toxicosis. AST has similar results that are considered permissible for pregnant women. This enzyme should be up to 31 units / ml.

Raising is possible:

in heart disease;
with the pathologies of the liver.

Both enzymes may exceed the permissible parameters when various diseases appear. Most often they are associated with blood problems, liver, heart, overweight. If this level is raised at the very beginning of pregnancy, there are no reasons for concern.

Why the level of Alt and Ast may increase

What is the norm of Alt and Ast, which is why the transaminase level increases? Pregnant women can Alt and Ast exceed the norm, but this is a temporary phenomenon. If the parameters do not come to normal, this indicates the development of pathology.

In other cases, the reasons for the increase may be as follows:

The number of enzymes can increase with various changes in the tissues of the liver. The reason may consist in the development of hepatitis. At the same time, the patient appears a yellow tint of the skin, pain in the right hypochondrium, stomach swept. This will accompany the increase in bilirubin performance. In terms of the level of enzymes, it is possible to judge the development stage of the disease.
Myocardial infarction can cause the death of muscle cells of the heart. Enzymes will be released into blood, the patient will feel pain in the heart area and the entire left side of the body. The attack will last about 30 minutes. A shortness of breath will appear, the total weakness, dizziness and feeling of fear.

Indicators may exceed the norm in various heart problems. If the disease is chronic, there is a sustainable increase in the level of AST and Alt in the blood. The pressure will be reduced, the patient will breathe hard.
It is possible to identify an elevated level of enzymes in the blood after injury. It contributes to burns or severe wounds.
The development of pancreatitis will be accompanied by an increase in blood enzymes. Painting sensations in the abdomen, weight loss and intestinal disorders also accompany the change in blood parameters.

To eliminate health problems during the baby tooling is not worth it. Therefore, when an AST and Alt level is exceeded, it is necessary to make blood test and find out the true cause of changes in parameters.

Hepatic test

During pregnancy, there is always liver samples of the future mother. This is done once every 38 weeks. This procedure is to conduct blood analysis in order to identify any pathological processes.

Features of such analyzes in pregnant women:

Indicators may differ from the pregnancy.
The child's hatching can cause the manifestation of chronic diseases, their exacerbations. In some cases, pregnancy can provoke the development of complications.
After the birth of the baby, analyzing indicators return to normal if their change was associated only with this process.
Pretty rarely future birth can cause complex liver problems. But such pathologies can affect the development of the child and the course of pregnancy.

Therefore, it is very important to carry out a blood test for your mother.

Mandatory is to check the level:

GGT (gamma-glutamyltranspend of gamma);
alkaline phosphatase;
bilirubin.

It is recommended to apply to female consultation in early pregnancy, in order to go through the necessary examination on time and identify deviations from the norm. Blood analysis will allow you to detect any changes in the work of the body and the development of the fetus.

Dynamics of the testimony of ALT and AST and the analysis value

How is Alt and Ast differ during pregnancy from the norm? Alaninotransferase is located in liver cells, and any changes in its tissues provoke an increase in the enzyme level. Using the definition of this specific marker, complex diseases are detected.

How the indicators of Alt change in normal pregnancy development:

In 1 trimester there is an increase of 5 to 10%.
In 2 trimester, an increase of 5 to 10% can occur.
In the 3 trimester, the indicators should return to the norm.

The AST enzyme is present in the body in two forms:

mitochondrial - 70%;
cytoplasmic - 30%.

According to the secretions of AST, one can judge the degree of damage to the authority. And during pregnancy, a false increase may occur due to the destruction of red blood cells.

The level of AST on trimesters:

In the first trimester there is a decrease of 5 to 10%.
In the second trimester there is a decrease of 5 to 10%.
In the third trimester, the level comes back.

There is one feature - after childbirth, the AST level can increase directly due to the generic activity.

Increasing the level of enzymes AST and Alt can warn about the start of the development of the disease.

For example, with a heart attack, Alt indicators will be more than 150%, the AST results will exceed by almost 500%. With the origin of hepatitis on analyzes, it will be possible to reveal it 2 weeks before the appearance of obvious symptoms. This refers to a virus A or V. This will make it possible to begin timely treatment, and the recovery period will take a little more than a month.

According to the results of such analyzes, you can identify health problems during pregnancy and take the necessary measures. Treatment occurs with the use of drugs and compliance with a special diet. If there are no indications for the operation, the generic activity is carried out naturally.

Therefore, preventive inspections needed and the entire period of pregnancy is observed at the doctor.

All women who can take offspring are needed:

Plan the conception of the child.
Pre-pass a medical examination.
If any signs of deviation appear in the results of the analyzes, establish a true cause.
Try to avoid infection by any viruses.
Perform all the recommendations of the doctor.

The level of AST and Alt may vary during pregnancy. In some cases, this is a natural process, but there may be a more serious reason for such deviations. This can cause early generics or interruption of pregnancy for medical records.

Together, this leads to the development of various diseases and complications that affect the development of the fetus. One of the important analyzes to determine the overall condition of a pregnant woman is a biochemical blood test, which pays particular attention to the indicators of ALT and AST.

Features of Alt and Ast enzymes

Description and norm of indicators of Alt and Ast

Some of the leading enzymes actively involved in the development of many groups of amino acids are Alt Transaminases (Alaninotransferase) and AST (AspartataminTransferase). The place of education and localization of AST are red blood tales, as well as muscle tissues and liver.

The indicators of ALT and AST differ in each other and depend on:

Patient age
Sexuality
Body masses
Lifestyle

The presence of such enzymes is also noted in the body of a completely healthy person, and men have their number a little more than women. In the event that the studied studies show an increase in these enzymes, this may indicate the development of various diseases in the body.

For the formulation of an accurate diagnosis, specialists are conducted by repeated biochemical blood tests for several weeks, and in parallel with these anamnestic data is being taken.

In medical practice, the definition of the concentration of ALT and AST is carried out according to the results of biochemical tests.

To obtain accurate and objective information, it is best to test the blood test in the first half of the day on an empty stomach.

Noram of Alt and Ast indicators has significant differences:

For women, the concentrations of enzymes up to 31 units are considered good results.
In a strong sex, the ALT indicators should not exceed 45 units / ml, and the concentration of AST should be placed within 47 units / ml.
During pregnancy, the indicators of Alt in the body of a woman may be contained up to 35 units / ml, and AST is up to 31 units / ml.

In the event that the indicators of these enzymes are significantly increased, this is an indicator of the progression of a person's organism of various pathologies.

End of the indicators of Alt and Ast during pregnancy

Deciphering the indicators of ALT and AST during pregnancy

One of the basic tests during the baby tooling is a biochemical blood test. Such a study is necessarily accompanied by an assessment of enzymes - those specific proteins that take actively participating in various biochemical reactions.

Most often, the attention of specialists during pregnancy attract such enzymes as:

Alt takes an active part in metabolic processes, and its large amount is contained in the liver and kidneys. During pregnancy, the permissible content of Alt in the body is considered to be up to 35 units / ml.

In the event that the studied studies diagnose the increase in this enzyme, this may indicate the development of such pathologies in the body of a pregnant woman as:

Liver liver disease
Toxicosis of pregnant women

Increased concentration of AST enzyme is observed in such organs as:

More information about the analysis of blood to Alt and Ast enzymes can be found from the video.

Diagnosing an insignificant exceeding the permissible AST indicators may cause suspicions to develop such complications as in Odianka or the kidney atology is easy or moderate.

During pregnancy, the allowable content of this enzyme in the body of a woman is considered up to 31 units / ml.

In the event that the AST indicator greatly exceeds the permissible values, then experts may suspect progression in the body of a woman of such pathologies as:

Myocardial infarction
Thrombosis of pulmonary arteries
Muscle injuries of different character
Failures in the process of bile outflow
Patology of the pancreas of an acute character

Reducing the indicators of Alt and Ast

Transaminase Alt and Ast are one of the important medical records, according to the results of which you can diagnose deviations in a state of health as children and adults. The increase in the content of these enzymes makes it possible to conclude about the flow of diseases of infectious diseases, various injuries and damage to organs as a result of age-related changes.

The process of reducing the increased concentration of ALT and AST in the human body can proceed independently and it begins immediately after the elimination of the main reasons that caused the development of the main disease.

Conducting various studies during pregnancy, the leading place among which belongs to the biochemical analysis of blood, allows us to identify pathology and prevent its further progression.

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Norms of Alt and Ast during pregnancy

Alaninaotransferase or Alt is an enzyme that is in the cytoplasm of liver cells and some other organs (skeletal muscles, myocardium), where its activity is much lower. Any damage to the liver cell membrane leads to an increase in the level of Alt in the blood. Alt is the most specific marker of inflammatory liver damage.

Why give the blood test to the child

During the 1st and 2nd trimesters of pregnancy, the level of Alt in the blood can decrease by 5-10%, and in the 3rd trimester - fully corresponds to the norm.

The norm of Alt in the blood is 0.1 - 0.78 μKat / L.

The reasons for the increase in Alt in the blood during pregnancy are the same as outside it.

Aspartataminotransferase or AST is present in the liver, myocardium, muscles, kidneys, pancreas and erythrocytes. AST is in two forms - mitochondrial (70%) and cytoplasmic (30%). Isolation of cytoplasmic AST, which is less, occurs with moderate damage to the liver. And the mitochondrial (which is 2.5 times more) stands out with more severe destruction and achievement of the pathological process to mitochondria.

The false increase in AST during pregnancy may occur as a result of the hemolysis of the erythrocytes, i.e. Isolation of the erythrocyte fraction of AST.

In the 1st and 2nd trimester of pregnancy, the level of AST in the blood can decrease by 5-10%, and in the 3rd trimester - must fully comply with the norm. After childbirth, AST can grow due to active muscular generic activities.

Gamma-GlutamilTransferase

Gamma-glutamiltransferase or GGT grows in cholestuza - broken promotion of bile with the bile. GGT is reduced in the 1st and 3rd trimesters of pregnancy, and in the second, it can grow slightly. With sharp and exacerbation of chronic liver diseases, GGT rises.

Alkaline phosphatase

Alkaline phosphatase or SFF rises in case of liver and bone diseases. Schf in adults is more indicative in the liver cholestasy in pregnant women. The values \u200b\u200bof the priest in blood in pregnant women change with each trimester. In the first third - may decrease, and in the second and the third increases. In the second - by a third of the norm, in the third - an increase of up to 2 times.

Alkaline phosphatase rate of 0.7-2.1? Kat / L. In the third trimester can reach 4.2? Kat / L.

Common Bilirubin

Bilirububes is formed in the process of hemoglobin metabolism. Displays liver. In the blood of pregnant Bilirubin in the first second trimester, it can decrease by%, and in the third - by 10-30%. If a pregnant woman in the results of hepatic samples detect an increased level of bilirubin - it is worthwhile to contact a doctor to establish a cause. Most likely the exacerbation of chronic liver disease or infection with viral hepatitis.

The norm of a common bilirubin in blood is 3.4 - 17,1? MOL / L.

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Norm Alt and Ast in Blood

A biochemical examination allows you to determine violations in the work of many organs, including liver and heart. AST shows violations in the heart of the heart, and the Alt is in the functioning of the liver. If the level is increased, what can it mean? What indicators of these parameters are considered the norm, and what are the climbing?

When the decoding is made, the norm of the indicators of Alt is considered digit mol / (C L) and 0.10-0.69 μmol / (ml h).

For an AST indicator, NMOL / (C L) or 0.10 - 0.46 μmol / (ml h) will be normal. These are indicators that are taken into account in the method of Frenkel and Rythman, AST in a child has other indicators.

If the blood test is performed using an optical test, then at 30 ° C, the norm will be 2-25 months, the child will be changed.

The strongest increase in the indicators of Alt occur during diseases of the liver. Especially this affects the appearance of hepatitis. If the liver cirrhosis processes are observed, the AST will exceed the ATL indicator.

If the blood test showed that an AST is increased in two or more times, it can talk about the presence of myocardial infarction. If the AST is first elevated, and then it decreases after 4 days, the infarction was most likely not.

The child Alt should not have more than 50 units per liter, and AST is 55 units per liter (up to 9 years). The newborn child AST will persist at the level of 140 units per liter (up to 5 days).

Causes of increasing Alt.

After the decryption of the data is completed, it can be found that the ALT increases not only for diseases of the liver, but also with problems with other organs. However, most often precisely the disease of the heart and liver lead to an increase in this indicator. List of diseases for which Alt is elevated, such: cirrhosis, tumor formations in the liver, jaundice, dystrophy fat in the liver, hepatitis, motion of cells, pancreatitis, liver problems during pregnancy, liver damage due to toxicological lesions, some infectious diseases, Myopathy, myocardial infarction, myocarditis, bone fractures, muscle breaks. Some substances and drugs also lead to the fact that Alt rises.

The reasons for the decline of Alt.

After the biochemistry decoded is carried out, it can be found that in some diseases, the Alt level may decrease. Oddly enough, but the reduction of the level of Alt is most often not related to the work of the liver. Such diseases include infectious infection of the urogenital system, tumor neoplasms in various places of human body, hepatitis (alcoholic), disadvantage of 6 due to improper diet or too frequent use of alcoholic beverages.

Treatment of elevated levels of Alt and Ast

To reduce the indicators of Alt and Ast, it is necessary to deal with the analysis parameters. If the analysis will show the deviations in the blood, this will indicate the presence of one or another disease in the body. In order to reduce the level of Alt and Ast, you must first remove the focus of the occurrence of the ailment, because of which the increase in the indicators of Alt and AST in the blood arose.

It is necessary to properly organize a healthy diet. It is important to use a large number of vegetables and fruits, the brown rice will be extremely useful. These products contain fiber. In addition, you should drink green tea or any herbal teas. They will help not only clean the liver, but also lead to the normal water balance of the whole organism. Very well helps tea from dandelion, burdock, milk thistle. Be sure to take products that contain a high level of vitamin C. You can drink the medicine rises. For every kilogram of weight you need to drink at least 30 ml of pure water (not juices, drinks and tea). Well help breathing exercises. It is important to exercise in the morning or play sports.

It must be remembered that treatment should not be carried out to improve data parameters in blood analysis, and in order for a fellow man to recover. The doctor must first of all think not about reducing the indicators, but on how to determine the hearth disease and remove all inflammatory processes. Then the indicators themselves come back.

Considering the fact that ATL is increased only when damaged liver cells, the doctor must register not only medications for the treatment of damaged organs, but also those drugs that are called hematoprotectors. They make it possible to secure hepatocytes from the influence of other aggressive factors.

In addition, any doctor must remember that the liver during this period is weakened, it cannot be at risk, since it can be even more damaged, therefore, drugs that have toxic effects on the liver are strictly prohibited. In other words, it is impossible to use drugs that can cause hepatic cells to die even faster.

The best hepatoprotectors are those who are designed on a vegetable basis. These include hepaben, Essentialy N, Levnyon, Phakveol, Carsil. These medicines have a positive impact on the liver. First, they protect the cells from further defeat. Secondly, they have the ability to restore liver cells, i.e., those cells that are damaged, but not yet died, can be restored due to the use of these drugs. In addition, they do not have toxic effects on other organs. These drugs take part of the liver functions, i.e. they can perform a secretory function, to participate in metabolism, as well as perform a disinfecting function, partially destroying toxins in the injury body.

K +, Na +, Cl-, Mg, P, Fe

Norms of biochemical analysis of blood during pregnancy

Bilirubin is a blood pigment formed as a result of the decay of hemoglobin, a change in the concentration of which is directly related to the condition of the liver and spleen.

Bilirubin is two species (fractions): direct (or related) and indirect (free or non-associated), and their amount gives a quantitative assessment of a common bilirubin in human blood. Norm of indirect bilirubin - 3.4-13.7 μmol / l, and direct - 0-7.9 μmol / l. Then the regulatory content of the total bilirubin in the blood is within 3.4-21.6 μmol / l.

As a rule, in the results of biochemical blood test, general and direct bilirubin are displayed, and their difference, respectively, will be the amount of indirect bilirubin in human blood.

In diagnostic purposes, the level of bilirubin is useful in determining jaundice, liver diseases, cholestasis, hemolytic anemia, infectious mononucleosis. With these diseases, an increase of both direct and indirect bilirubin is observed.

During pregnancy, it is often an increase in the indirect bilirubin with normal hemoglobin testimony, Alt, AST, GGT and direct bilirubin, as well as with a good ultrasound of the liver and gallbladder. There is nothing terrible in this, such a phenomenon is called the Zhilbera syndrome - this is a congenital disease that remains throughout life and is not risking for the development of the child.

It is recommended to take Essentialy Fort N 2 capsules 3 times a day (during meals) for 1-2 months and enterosgel 1 tablespoon 3 times a day (1-2 hours before or after meals, weaving with several sips of water) For 10 days to help your liver cope with the load, as well as adhere to the right nutrition, it is impossible to hungry - it is impossible!

Alaninteransaminase or Alaninotransferase (Alt or Alat) is an intracellular enzyme, which is largely in the liver and kidneys, in less quantity - in the heart muscle, lungs, pancreas and spleen.

Alt Alt Enzyme in the blood of a woman - up to 31 units / ml.

In the destruction of the cells of these organs, there is a significant emission of Alt into the blood, which happens with hepatitis, fat hepatosis of the liver, jaundice, toxic lesion of the liver, pancreatitis, heart diseases and other serious diseases.

With late toxicosis (pregnancy) during pregnancy, an insignificant increase in Alt may be observed.

Aspartataminotransferase (AST) is an enzyme, which as well as Alt participates in the exchange of amino acids and is contained in the cells of various human organs.

The agent of AST in the blood in women is up to 31 units / ml.

Increasing the level of this enzyme most often indicates the problems with the heart (in particular, with myocardium), as well as on liver diseases.

There are liver causes of the increase in ALT and AST - liver ischemia, viral hepatitis, hepatosis of the liver, and not hepatic causes - hemolytic anemia (hemolysis), obesity, etc.

An insignificant increase in Alt and AST enzymes in the first and second trimester of pregnancy is not a consequence of the disease.

Creatine is a product of creatine phosphate exchanging, which is involved in the process of ensuring human muscles.

Creatine is filtered in the kidneys, and in the event of a violation of their work, it is observed an increase in Carelenain in human blood.

Regulatory concentration of creatinine in the blood of a woman molmol / l.

During pregnancy (as a rule, in the 1st and 2nd trimesters) there is a decrease in this indicator by 40% due to an increase in blood volume, reinforced kidney work, i.e. The creatinine content during pregnancy is reduced by the domkmol / l, which is a physiologically normal phenomenon.

When you are too thin build in a pregnant woman or under a vegetarian power supply, this indicator can also be reduced that, in this case, this is a bad sign, you need to gain weight, balancing and balanced the power.

Urea is a nitrogen-containing product, which, along with creatinine, it makes it clear how the excretory kidney system works.

Cholesterol (or cholesterol) is an important building component of the cells of our organism, most of which is produced in the liver, the rest - a person gets food with food. Also, cholesterol is involved in the development of sex hormones, so follow the level of cholesterol and maintain it normally is important to task during the child tooling.

Cholesterol standards according to the age of a woman, mmol / l: with normal general blood performance, a double increase in cholesterol during pregnancy is the norm, that is, each indicator of this table must be multiplied by 2. Such an increase is due to the active emissions of certain hormones into the blood of the woman necessary for the formation of the placenta .

Increasing the value of cholesterol (namely, on average, the testimony of the Bolhemol / L) is observed in the diseases of the liver, cholestasis, pancreatitis, renal failure, ischemic heart disease, diabetes, obesity, etc.

As for the baby, and for mom, elevated halestaterine is an extremely unwanted phenomenon, so it is necessary to take measures to reduce it: change the diet to a lower calorie, perform exercises for pregnant women, etc.

After all, with an excess of Halestterina, the risk of intrauterine abnormalities in the development of the cardiovascular system in the fetus increases, and the mother itself may suffer to a decrease in the strength of the vessels, their blockage and the formation of thrombus, during the lack of the risk of spontaneous miscarriage or prematurely, and in a pregnant woman with reduced cholesterol is observed deterioration of well-being.

Glucose is the main blood marker to determine diabetes in humans. Blood glucose rate - 3.89-5.83 mmol / l, but during pregnancy healthy women This indicator is often reduced, because the fruit is growing and it needs more glucose, which it consumes from the mother's body.

Also during the baby tooling the child, pregnant faces gestational diabetes, which disappears after delivery. These phenomena are considered within the normal range, as they are caused by the active release of the organism of the Mother of Glucose and its consumption of the developing fruit.

The increase in blood glucose speaks of diabetes mellitus, renal and liver diseases, pancreatitis.

The decrease in glucose can also be in endocrine pathologies, for example, with insufficiency of adrenal glands.

Diastase (or alpha-amylase) is an enzyme that is synthesized in the pancreas and in salivary glands, in small quantities is present in the liver and intestines, so this blood marker is used primarily to diagnose pancreatic diseases and inflammatory processes in salivary glands, well And of course, to confirm the diseases of the liver and the gastrointestinal tract.

Norm for an adult person / l.

The increase in the level of diastasis in the blood is observed in pancreatitis, cholecystitis, renal failure, diabetes mellitus, etc.

And lowering the level of diastasis - with toxicosis, hepatitis, pancreatic deficiency.

Gamma-glovedransferase or gamma-glovedranspend of gamma (GGTF (GGTF) or GGTP) is an enzyme that accumulates in kidneys, liver and pancreas.

GGT norm for women - up to 36 units / ml.

Throughout the second trimester of pregnancy, GGT can be slightly increased that within the normal range.

With the diseases of the liver and the biliary system (cholestasy, for example) there is a significant increase in serum enzyme. May increase GGT and with diabetes mellitus.

Alkaline phosphatase (CFF) is an enzyme, which is mainly involved in the growth of bone tissue.

The norm of alkaline phosphatase in women / ml. Normal is considered to increase this enzyme when the fractures are overgrown.

In pregnant women in the second and third trimester, an increase in alkaline phosphatase may be observed, which is due to the active growth of bone fetus.

Also, the increase in the CFF can speak of the presence of bone disease or liver (for example, with a liver cholestasy, hepatitis).

Also, in the infectious mononucleosis in the first week of the disease, the growth of SFF is observed.

Acceptance of antibiotics, magnesia, large doses of vitamin C, the insufficient use of products rich in calcium and phosphates also increases the level of alkaline phosphatase in human blood.

K + (Potassium), Na + (sodium), CL- (chlorine), Mg (Magnesium), P (phosphorus), Fe (iron) are the main inorganic substanceswho play an important role in the work of the whole organism. Each of them is responsible for certain important processes: for muscle contractions, carrying out nerve impulses, metabolism in the body of a person, for maintaining a somatic pressure, compliance with acid-alkaline balance, nervous system operation, oxygen transmission, etc.

Both an increase and decrease in the content of macro- and trace elements in the body of a pregnant woman leads to health problems and a child, and not yet born baby, therefore it is important to maintain these indicators in the norm with the help of adoption of specially developed vitamin and mineral complexes for pregnant women.

Biochemical blood test must be handed over in the morning and on an empty stomach, and the last reception of food should be 8-12 hours before delivery.

Alcoholic liver disease (ABP) is one of the most common causes of chronic liver disease in the United States.

Developing in patients who consume more chambers of alcohol per day (5 standard doses of "Drink" per day), and in women 2 standard doses per day. The diagnosis of the ABP is confirmed by an increase in the maintenance of trascheraz at the AST ratio: Alt at least 2: 1. The level of transferases is a useful test to identify alcohol abuse. The increase in AST is a more specific test to identify alcohol abuse.

In this case, the identification of GGTP is also useful. Increasing the content of GGTP more than 2 times with the AST ratio: Alt at least 2: 1 - the surround argument in favor of alcohol liver disease.

The role of medicines, herbs and other substances

Mattering anamnesis and analysis of laboratory data is important for the diagnosis of drug-and-enhanced aminotransferase increases. Drug and chemically induced liver damage make up 1-2% of cases of chronic hepatitis. Chronic liver lesions are associated with antibiotics, anti-epileptic drugs, hydroxymethylglutaryl-soa reductase, NSAIDs and anti-tuberculosis drugs

The easiest way to establish a link to increasing aminotransferase with a drug is to cancel it and observe how it will affect its level. Without cancellation of the drug, this connection cannot be installed.

High risk of chronic hepatitis C (HCV) in patients with parenteral administrations, drug addicts, tattooed persons, sexual minorities. The most effective method of diagnosis is the definition of antibodies to the HCV virus (sensitivity of over 90%), which is usually confirmed by PCR.

In most patients with HCV infection, an increase in Alt is 1.5 -2 times higher than AST. In the development of cirrhosis in patients with viral hepatitis, the ratio of ALT / AST is normalized or AST is somewhat increased.

HBV DNA captions more than 105 copies / in ml and the increase in Alt is an indication for liver biopsy and antiviral therapy.

An autoimmune hepatitis (AIG) is more often found in young middle-aged women. The cost of men and women is 4: 1. Determination of proteins in serum proteins - useful screening test.

With more than 80% of patients with AIG, hypergammaglobulinemia is celebrated. Exceeding regulatory indicators more than 2 times is very important to establish a diagnosis. Additional serological tests include definitions of anti-nuclear antibodies, anti-thunder antibodies, antibodies against smooth muscles, liver kidney microsomal antibodies, but sometimes they are negative for reliable diagnostics requires biopsy.

Non alcoholic liver disease (click) The prevalence of the USA among the population of the United States is 20% (.), And the estimated prevalence of NA3% otherwise from patients with alcohol hepatosis The AST / Alt ratio in patients with NAZ is less than 1: 1.

Traditionally, it is believed that that the NP is more often striking, diabetics, middle-aged women. Currently it has been established that the NAG may affect not fat people without diabetes.

Fat lesions of the liver can be associated with medicines such as prednisone, methotrexate, synthetic estrogens, amiodaron, tamoxifen, nifedipine, and dithiam. Nash may be a consequence of the massive effects of organic solvents, durable parenteral nutrition and non-spoile rare hereditary diseases.

A number of patients may evolve into cirrhosis, and therefore, as far as aggressive diagnostic methods we must enjoy - an ambiguous issue.

Ultrasound or CT often help identify the "fatty liver", but there are currently no effective techniques for its treatment. Vitamin E, Ursodol, and medicines used to treat sugar diabetes of the second type are intensively investigated in connection with this.

Currently, basic treatment is in the normalization of weight, diabetes control and treatment of hyperlipidemia.

Other less frequent causes of improvement of aminotrase

Given the presence of other reasons for an increase in aminotrase, the patient must be examined to eliminate the following diseases. These diseases are relatively not often found. To confirm the diagnosis, biopsy is often required.

Hemochromatosis (GC). This disease is found in 1 of 300 people in a common population. With GC, ferritin in serum is elevated and increased the percentage of iron saturation and confirmed by the presence of 2 copies of HFE - gene.

Characteristic manifestations: the patient is observed lethargy, arthralgia, a decrease in libido, but often there are cases of immanent. In this regard, the beginning of treatment is delayed. It is necessary to think about GC with a slight increase in liver enzymes.

Wilson disease (BV). Genetically deterministic violation of biliary excretion of copper. BV can manifest itself exclusively by increasing the level of hepatic enzymes. There is a disease between the ages of 5 and 25 years, but is diagnosed more often by 40 years. It occurs approximately 1 island. Specific symptom of the rings of the Kaiser of Fleischer, the low level of ceruloplasmin, an increase in the release of copper with urine, a high concentration of copper in the liver. Deficiency? 1- antitripxin. Not a rare hereditary disease of young people of white race, affecting the liver. Reduced? 1- antitripxin is up to 20% of the norm and decline? 1- globulin during electrophoresis. The diagnosis is confirmed by determining the fenotype of protease inhibitor.

A low-rise celiac disease (SPRA). Coleciakia-Spring Frequent cause of changed hepatic tests. Diagnosed on the basis of the definition of anti -iadine, and tissue transglutamine antibodies. These indicators should be determined especially in cases where the weight loss is noted, the stomach voltage, flange and steatheree (although these symptoms may be absent). According to the latest data, the celiac disease was the cause of a persistent increase in the content of aminotransferase in 14 of 140 patients directed to the hepatological clinic.

Increased Alt may be observed in patients with obstructive hepatobiliary diseases, infiltrative liver disease, including primary and metastatic tumors, drug-induced liver diseases, primary biliary cirrhosis.

A light increase in Alt is observed in the first trimester of pregnancy and the physiological growth of bones and not often among the elderly patients over 50 years old. Diagnostics helps the definition of serum 5'Nucleotidases or GGTP levels, which are rising simultaneously with Alt with liver diseases.

The increase in the conjugated bilirubin may occur in viral, chemical, or alcohol-induced lesions, as well as when obstruction of the biliary tract and with cirrhosis.

Zhilbera syndrome is the most common reason for increasing the level of non-contiguous bilirubin at normal hepatic tests - occurs in 5% in the population. Hemolysis can be differentiated from the zhilbera disease on the content of reticulocytes, the number of erythrocytes and blood microscopy. For hemolysis, reticulocytosis is typical, anomalous microscopy, whereas with the zhilber disease these indicators are normal.

When to apply visualizing methods and biopsy? Reserve the use of visualizing methods for cases when the ALT and / or AST are elevated, and all other tests are normal.

Visualization is especially useful when Alt or GGTP is increased. Studies should be directed to the detection of biliary obstruction of the intrahepatic (liver tumor) or an extrahepatic (tumor or stones of blocking bile moves).

The liver biopsy is shown to those patients whose AST or Alt is increased more than 2 times compared with the norm and other pinchenic samples or visualizing methods of negative.

"If the level of ALT and AST is increased less than 2 times compared to the upper limit of the norm and is not identified by chronic liver disease, only observation is recommended."

The basis for this notes was the article:

Marshall M. Kaplan, Emmet B. keeffe. What do abnormal LIVER FUNCTION TEST RESULTS REALLY MEAN. Published in Patient Care For the Nurse Practitioner, May 2003.

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Iimacy

I am pregnant - all about pregnancy, childbirth and children (0.038 sec.)

Assumption Julia Borisovna, Ph.D., Ved. Scientific Sot., Kuznetsova Irina Vsevolodovna, D.M., Prof., Ch. Scientific Sot. Research Office Women's Health NIC GBOU VPO First MGMU. I.M. Suchenova

The most clinically significant indicators in the laboratory diagnosis of liver diseases include enzymes from the Transaminase group, or aminotransferase: aspartataminotransferase (AST) and Alaninotransferase (ALT). Increasing the level of these enzymes is a sensitive marker damage to the liver tissue.

Over the past decades, there has been an increase in the number of cases of detection of increased indicators of AST and Alt around the world. Thus, in the US, the increase in transaminase level is determined by almost 10% of the population. Isolated increase in AST and Alt during pregnancy in clinical practice often causes interpretation difficulties. This is not only associated with the need to exclude a wide range of liver diseases, but also requires additional inclusion of pathologies inherent in the period of pregnancy. Indicators of hepatic AST and ALT only reflect the processes of damage to hepatocytes, but are absolutely not specific to the diagnosis of a particular liver disease. At the same time, the determination of the reasons for the change in the indicators of hepatic samples in a short time in pregnant women are extremely important due to significant differences in both the forecast for mother and the fetus and the tactics of treatment and maintaining patients.

Today, there are still no specific markers for the differential diagnosis of liver pathology, due to pregnancy, and the diagnosis is made on the basis of a set of laboratory and clinical data. Moreover, pregnancy is a restriction for biopsy with a morphological study of liver tissue, allowing in doubtful and diagnostically difficult cases to put the final diagnosis. In some cases, laboratory changes in hepatic enzymes can be the first and only sign before the formation of a complete deployed picture of hazardous complications of pregnancy: Preeclampsia, Eclampsia, Hellp-syndrome (Hemolisis - Hemolysis, Elevated Liver Enzymes - Enhancement of liver enzymes, Low Platelet Counts - Low platelet number ); Acute fat health liver (OZHPB).

Often this leads to incorrect conclusions about the etiology of the disease and the choice of incorrect treatment tactics, which is unacceptable in this category of patients. As a rule, an isolated increase in transaminases, no more than 5 times, in asymptomatic patients in the second half of pregnancy, is randomly detected with a planned examination or with a comprehensive examination of pregnant women with clinical symptoms of gestosis / preeclampsia, eclampsia.

Conditionally, it is possible to divide the reasons for increasing hepatic transaminases on obstetric and non-obstetrics.

Obstetric causes GuestRose / Preeclampsia, Eclampsia

First of all, when detecting an isolated increase in transaminases in pregnant women in terms of more than 20 weeks of gestation, alertness is needed to be hidden or subclinically developing gestosis / preeclampsia and their heavier manifestations.

The terms "Preeclampsia", "Eclampsia" used abroad, or the term "prestal", still used in domestic clinical practice, is denoted by the syndrome of polyorganic functional insufficiency, pathogenetically associated with pregnancy characterized by generalized vascular spasm and perfusion violations in vital organs And placenta. The prevalence of gestosis in recent years remains steadily high and varies, according to various sources, in the range from 7 to 22%. The alertness against preeclampsia in pregnant women with an abnormal increase in liver tests in the second half of pregnancy is determined not only by its prevalence, but also the high significance of this complication of pregnancy in the structure of the causes of perinatal morbidity, maternal (10.8%) and perinatal mortality (18-30%) .

Characteristic and significant in the differential diagnosis of changes in hepatic samples during gestosis / preeclampsia are arterial hypertension, proteinuria, thrombocytopenia, an increase in creatinine, edema. When engaging the liver into systemic lesions with preeclampsia possible, but not constant symptoms are pain in the epigastric region, nausea, vomiting. The severity of an increase in AST in predose may have prognostic value: the level of more than 75 URS / L is regarded as significant, and exceeding 150 units - is associated with an increased risk of complications from the mother.

Hellp syndrome

Hellp syndrome is a rare severe complication of gestosis and is accompanied by a variety of clinical manifestations. The disease is observed in 0.1-0.6% of pregnancies and complicates the course of preeclampsia in 3-20% of cases. In the clinical picture there are headache, nausea, vomiting, visual impairment, swelling, ascites. It should be noted that it is not always that dangerous complication is accompanied by high lifting arterial pressure or proteinuria. With a laboratory survey, signs of hemolysis (reduction of haptoglobin, increasing the level of bilirubin, schistocytosis-fragmentedness of erythrocytes) are detected, the increase in AST and Alt is not more than 3 times, thrombocytopenia. In 12-65% of cases with HellP syndrome, severe, threatening life of the complications are developing: disseminated intravascular blood coagulation, premature celaiming placenta, acute renal failure, pulmonary edema, pronounced ascites, gap or liver infarction.

Another obstetric complication, accompanied by disorders from the liver and often combined with gestosis, is the OZHPB.

Acute fat liver pregnant women

A rare severe pathological condition developing with a frequency of 1 to 7000-16,000 pregnancies. It is characterized by high maternal (7-18%) and perinatal mortality (9-23%). At the heart of the pathogenesis of the disease lies an innate violation of the processes of mitochondrial B-oxidation of fatty acids with the development of pronounced fine-flowered infiltration of the liver tissue, acute hepatic insufficiency and encephalopathy. The disease is preferably manifest in the third trimester of pregnancy. Clinical manifestations are nonspecific: weakness, fatigue, headache, nausea, vomiting, pain in the epigastric region or in the right hypochondrium, jaundice. Frequently combined with preeclampsia, the disease can be accompanied by arterial hypertension, proteinuria, ascite. When developing disorders in the blood coagulation system, coagulopathic bleeding occurs. Progression of liver damage with the development of hepatic insufficiency is accompanied by signs of encephalopathy: arousal, confusion, drowsiness, coma.

With a laboratory examination, significant leukocytosis is determined (up to 20-30 ¥ 109), thrombocytopenia. An increase in liver damage markers is revealed: an increase in AST and Alt, as a rule, up to 300-500 units. In severe cases of significant damage to the liver tissue, the increase in transaminase indicators can be deceptive-moderate, but this indicates a massive necrosis of hepatocytes and the impossibility of synthesis in them AST and ALT. Alkaline phosphatase and bilirubin levels increase, mainly due to the associated. Disorders of the synthetic function of the liver are reflected in hypoglycemia, a decrease in prothrombin, fibrinogen and an increase in prothrombin time. When joining pancreatitis, elevated amylase and lipase indicators are determined. It is possible to increase the level of creatinine, uric acid.

With ultrasound examination, a decrease in the echogenicity of the liver parenchyma is determined, which, however, is not strictly specific for the OHPB.

The most difficult is the differential diagnosis of OZHAPB with HellP syndrome due to the possible crossroads of clinical and laboratory manifestations and their frequent combination with gestosis. Pronounced jaundice, hypoglycemia, signs of encephalopathy are arguments in favor of the OZHPB.

In clinical practice, in the reveal of raising hepatic transaminases in the late periods of pregnancy, in the absence of any clinical symptoms and changes in other laboratory indicators (or without their definition), the diagnosis of intrahepatic cholestasis of pregnant women (VHB) is unreasonably raised, based on the presence of signs " liver. " Indeed, VHB occupies a 2nd place among the causes of yellow pregnant women, but also has a number of characteristic clinical and laboratory signs.

It should be recalled that the pathogenesis of HBB is based on, first of all, cholestasis with a violation of the outflow of bile from the biliary tubules under the influence of high levels of sex hormones in predisposed persons, which is accompanied in the overwhelming majority of cases with pronounced skin itch. The role of a genetic predisposition to the development of a cholestatic reaction to high levels of estrogen and progesterone, both during pregnancy and when taking the preparations of female sex hormones. In 45-70% of cases, VHB recurrences with subsequent pregnancies. Confirming laboratory cholestasis markers are an increase in the indicators of bile acids, bilirubin, alkaline phosphatase, G-glutamaltranspendase, and when joof the jaundice - urobilinuria.

Liver transamaminases are not always rising, as a rule, moderately, and reflect the secondary damage to hepatocytes against the background of a persistent cholestasis. Thus, the diagnosis of VCB is placed on the totality of clinical, anamnestic and laboratory data. The disease has a favorable forecast for the mother and is independently resolved after delivery. However, for the WCB fetus, it is associated with an increased risk of premature genera, respiratory disorder syndrome and high perinatal mortality. In this regard, tactics at VCB envisages the active management of patients with dynamic monitoring of the state of the mother and fetus, and in the development of the threat of complications - emergency delivery. It is for these reasons that the unreasonable formulation of the diagnosis of VCB in patients with an isolated increase in AST and Alt can send doctors to the wrong way of maintaining the patient.

In the absence of signs of described pathology, the next step in the diagnostic search is the elimination of the most frequent non-acute causes of increasing hepatic enzymes.

Non-achesive reasons

To the most frequent liver diseases, accompanied by an increase in AST and Alt, include chronic viral hepatitis, non-alcoholic liver disease (NAFF), medicinal hepatitis, alcohol lesion of the liver, hemochromatosis.

Viral hepatitis

Among chronic liver diseases, viral hepatitis B and from over the past years occupy a leading place. In addition, on any pregnancy, acute viral hepatitis can develop. Therefore, the diagnostic algorithm for examination of pregnant women with signs of damage to the liver tissue should include the serological determination of the acute viral hepatitis markers (A, B, C, D, and also caused by Epstein-Barr viruses, simply herpes, cytomegalovirus) and chronic forms of viral hepatitis B and C.

Non alcoholic liver disease

The most common cause of chronic subclinical inexplicable increase in transaminase in the population is NAFPP. This disease is recognized as the most common liver pathology in developed countries and is detected in 20-30% of the population, and its prevalence achieves 50-90% in persons with excessive body weight and obesity. The recognized and most significant factors in the development of NAFD include excess body weight, obesity, diabetes and fatty metabolic disorders. Taking into account this, and due to the rapid growth in the prevalence of overweight body and obesity around the world, in the coming years, the incidence of NAFLP is expected.

The key links in the pathogenesis of NAFLP are insulin resistance, hyperlipidemia and oxidative stress. The listed factors are accompanied by both physiologically occupied pregnancy, being part of adaptive changes, and may be a manifestation of deadaption in patients with complicated pregnancy and related extragationalital pathology.

A normally flowing pregnancy is accompanied by changes in carbohydrate and fat exchange, which is determined by influences from placental hormones. Inherent in pregnancy, insulin resistance, gradually developing and reaching a maximum in the late periods of gestation, is biologically advisable to maintaining euglecemia from the mother and to ensure the glucose of the fetus, 50% of the energy of which is carried out by glucose. This evolutionary mechanism formed ensures the increased needs of mother and fetal organisms in easily and quickly available energy substrates even at long intervals between mother meals. As the pregnancy period increases, the severity of the sensitivity of tissue sensitivity to insulin increases, and in the later dates, the insulin-dependent consumption of glucose decreases by 50%, and the secretion of insulin, on the contrary, increases by 200-250%.

During pregnancy, hormones with contrainzular action of placental (placental lactogen, progesterone, placental growth hormone) and non-collecting (growth hormone, cortisol, prolactin) of origin play a significant role in switching the metabolism of a pregnant woman to insulin resistant status. In recent years, the role and other factors in the formation of insulin resistance during pregnancy has been shown. These include an increase in concentrations of pro-inflammatory cytokines (tumor necrosis factor A - FN-A) and decrease in adiponectin. In addition, a substantial contribution to changes in fat exchange in late pregnancy is made by observed leptinoresistance and hyperleptinemia observed during this period.

The pregnancy is characteristic of the development of transient dlypidemia associated with an increase in the level of triglycerides, an increased formation of low density lipoproteins (LDL) and the maximum severity of these changes in the III trimester, similar to atherogenous dlypidemias observed in persons with an increased risk of cardiovascular diseases. During pregnancy, plasma levels of triglycerides increase by 200-400%, and cholesterol is 25-50%. The average concentration of LDL from 10 to the 35th week of pregnancy can increase to 70%.

Despite the fact that hyperlipidemia during pregnancy is considered a natural adaptive reaction, in some cases the adaptation mechanisms are disrupted with the development of supraphisiological hyperlipidemia, with indicators of a lipid profile exceeding the 95th percenter for this period of gestation. The reasons for this may be hereditary factors, initial and acquired during pregnancy impaired carbohydrate exchange, excessive body weight and obesity. Pregnancy, therefore, acts as a kind of metabolic stress test in the future of exchange violations.

Already from the 12th week of pregnancy, the concentration of phospholipids, cholesterol and triglycerides are increasing under the influence of elevated levels of estrogen on the background of insulin resistance. The transition to the catabolic type of metabolism switches the maternal exchange for the use of lipids as the main source of energy, thus redistributing glucose and amino acids for the needs of the fetus. In addition, maternal lipids, such as cholesterol, are needed as a plastic resource for constructing the fetal cell membranes, bile acid synthesis and steroid hormones. Free fatty acids (SZHK), oxidizing in the liver with the formation of ketone bodies, are "alternative fuel" for the fetus.

It is assumed that the high concentrations of placental lipase, placental genital hormones with lipolytic effects, supplemented by catecholamines in response to maternal hypoglycemia and insulin resistance, are responsible for mobilizing fatty depots, as a result of which the plasma concentration of the SVC and Glycerin gradually increases in the third trimester of pregnancy. The main addressee of lipolysis products released from adipose tissue is the liver, where they are converted, are included in lipoproteins, enter the bloodstream and further transported to tissues or spent as a substrate in energy product processes or used for glukegenesis. Pregnancy is associated with oxidative stress and even at its physiological flow increases the load on antioxidant systems. However, with its natural course, the balance between oxidative aggression and antioxidant protection is preserved. The decompensation of antioxidant resources with an imbalance of active forms of oxygen and antioxidants is developing during pregnancies complicated by preeclampsia, gestational diabetes, unbearab and fetal growth delay syndrome.

Many of the listed changing metabolism parameters during pregnancy are involved in the pathogenesis of NAFF. The role of FNF-A is known, in addition to participating in mechanisms for the development of insulin resistance, oxidative stress and inflammation processes, which make up the basis of steatogeatite, the second "stage" of NAFLP. Leptin plays a significant role in the development of fat hepatosis and fibrgenesis processes at NAFF. On the other hand, the increased content of the CFC in the blood leads to their seizure and accumulation in the liver, which initiates the development of oxidative stress, violation of the mitochondrial function and damage to hepatocytes.

Thus, physiological insulin resistance, hyperlipidemia, including supraphisiological, hyperlepping, decompensated oxidative stress, especially in the presence of such additional adverse factors, like obesity, excessive body weight and gestational diabetes, can be viewed as a foundation for the development of NAFLD in the second half of pregnancy. . Of course, the diagnosis of NAFS can be delivered only after the careful exclusion of other possible causes of damage to the liver cells. Patients with laboratory markers of cytolysis, testifying to the presence of steatohepatitis, require special attention and after childbirth to determine the condition of the liver and prevent possible further progression of the disease and the comorbide pathology.

Gemohromatosis

Frequently frequent hereditary disease associated with impaired iron exchange and its excess accumulation in the body. Inherited by autosomal dominant type of mutation of genes participating in iron metabolism, lead to its increased absorption in the gastrointestinal tract. Clinically disease manifests years of accumulation of iron in organs and tissues. As a rule, women debut disease develops later due to regular losses of iron with menstruation. The accumulation of iron in the liver, pancreas, the heart, the skin in the unfolded stage of the disease is associated with the appearance of different symptoms: weakness, fatigue, abdominal pain, arthralgia, darkening of the skin. For the diagnosis of hemochromatosis, serum iron levels, ferritin, common iron binding ability of blood serum determine. The genetic test on the gene mutations characteristic of hemochromatosis is also confirming.

Medicinal lesions of the liver

In recent years, there has been an increase in the prevalence of liver drug lesions around the world. At the same time, women are more susceptible to the development of hepatotoxic drug reactions than men. The reasons for this predisposition are unclear. Possible hypotheses suggest both greater congenital susceptibility of the liver tissue to damaging effects, as well as a higher adherence to women of medicinal therapy.

The pregnancy itself is a restriction for drug therapy due to the danger of adverse effects on the fetus, at the same time the steady increase in the prevalence of complicated flow and non-pregnancy, the presence of chronic extragenital pathology leads to the appointment of drug therapy from early terms and often throughout the entire pregnancy. In addition, women receive a high drug load before preparing for conception and in the future during pregnancy when using auxiliary reproductive technologies. The methods of auxiliary reproductive technologies are associated with the use of drugs, including hormone therapy, both before pregnancy in order to stimulate supervision and after its occurrence to maintain and prolong the pregnancy due to the high risk of its unbending. There are no accurate statistical data on the use of drug therapy in our country. It can only be assumed that these figures are large enough, even if they approached them with data from the United States, where drug therapy with one or more drugs that are not related to a group of vitamins and trace elements receives about 64% of pregnant women.

Potentially hepatotoxicity can exhibit any drug. Drugs that most often causing damage to the liver tissue include non-steroidal anti-inflammatory drugs, and in particular paracetamol, anti-epileptic agents, preparations of female sex hormones, vitamins A and E in high dosages, heparin and low molecular weight heparins, antimicotics, nifedipine. Gepatotoxic can be biologically active drug-based supplements. This list is far from complete, but we intentionally did not include drugs in it, absolutely contraindicated and not appointed during pregnancy.

Hepatotoxic effects can develop at any time from the beginning of drug intake, but more often during the first 1-2 months. In this regard, when the patients of elevated liver enzymes, careful collection of medicinal history is needed, including the reception of "safe, natural" biologically active additives. Typically, damage to the liver tissue is reversible, and after the cancellation of causal drug therapy, the biochemical liver damage markers are normalized, however, the data relative to remote drug-conditioned hepatotoxic effects is not enough.

After the exclusion of frequent causes of changes in hepatic samples at the second diagnostic stage, differential diagnosis includes rare liver diseases and extrahepatic reasons for increasing transaminases.

Increased aminotransferase serum serum can be both hepatic and extra-erased origin. In the body of AST and Alt - one of the most common enzymes involved in the most important processes of cellular cells, which, in addition to the liver, are present in the kidneys, skeletal muscles, cardiomyocytes, pancreas, brain, erythrocytes and leukocytes.

Extraked causes of increasing transaminase

Damage to muscle tissue, both with significant physical exertion and under congenital diseases associated with impaired metabolism in myocytes, and myopathy is accompanied by an increase in AST and Alt muscular fractions. An important differential diagnostic criterion in these cases is the simultaneous increase in the level of creatine phosphocainase.

Increased transaminase levels can be observed in diseases of the thyroid gland, which requires determining the levels of thyroid hormones (thyrotropic hormone - TSH, Tyroxin).

Tseliacia

Colecia - enteropathy, striking the delicate intestine in genetically predisposed children and adults, manifested with food containing gluten. Earlier it was believed that celiac disease is an extremely rare disease, but it is currently shown that its prevalence of 1: 100 to 1: 300 cases. Women suffer from celiacs 2 times more often than men. The symptoms of celiac disease are nonspecific (bloating, violation of the chair, a decrease in body weight, etc.), as well as the disease can proceed asymptomatic, despite the presence of changes in the small intestine. Thus, it complicates the formulation of the diagnosis, which years may take years. At the same time, in numerous studies, it is shown that the increase in hepatic enzymes can be detected with hidden celiac disease. Screening test on celiac disease is the definition of serological markers - antibodies to glyadin, tissue transglutaminase, endomise. When observing a gluten-free transaminase diet is rapidly returned to normal values.

Other reasons

The rare liver diseases accompanied by increasing transaminases include autoimmune hepatitis and Wilson-Konovalov disease, A1-antitripsin deficiency.

Autimmune hepatitis

More often detected in women of young and middle age. The disease may proceed both in acute fulminant form, and subclinically, asymptomatic or with non-specific and moderately pronounced symptoms. An autoimmune hepatitis is often associated with autoimmune diseases, such as the pathology of the thyroid gland, arthritis, etc. A complex of diagnostic indicators In suspected an autoimmune hepatitis, it includes the definition of anti-nuclear antibodies, hepatic and renal microsomal antibodies, antibodies to smooth muscles and detection of hypergammaglobulinemia during serum protein electrophoresis.

Wilson-Konovalov disease (hepatocerebral dystrophy)

A rare hereditary disease with an autosomal-recessive type of inheritance associated with a violation of copper secretion with bile and its excess accumulation in tissues, especially in the liver and brain, with the development of mental, neurological disorders and lesions of the liver, based on cirrhosis and liver failure. The disease debuts predominantly under the age of 40. Pathognomonic for the disease of Wilson-Konovalov are the detection of the Kaiser-Fleucher ring along the periphery of the horny shell of the eye, as well as the reduction of serum ceruloplasmin and excess medium of copper with urine.

A1 antitripsin deficiency

A rare hereditary disease associated with the mutation of genes encoding the formation of this protein. In addition to the lesion of the pulmonary fabric with early development The chronic obstructive disease of the lungs and emphysema at a young age, the disease can be accompanied by heavy, progressive changes in liver with the development of cirrhosis, which in the initial stages are manifest only by changing the laboratory indicators of hepatic samples. Screening includes the determination of serum content A1-antitripxin.

Conclusion

Thus, the identification of an increased level of hepatic transaminases in pregnant women requires the attention of clinicians, as it may be a manifestation of both complications of pregnancy and a different concomitant liver pathology. In some cases, even after the entire complex of diagnostic measures, in accordance with the survey algorithm offered by us, it is not possible to reveal the reason for increasing liver enzymes. According to the literature and its own data, with a stable state of the liver function and the absence of signs of its decompensation, the likelihood of the development of pregnancy complications is low.

Apparently, most of these cases of an inexplicable subclinical increase in AST and Alt is a manifestation of NAFF. In this regard, in obscure cases, patients should be monitored during pregnancy and after childbirth with dynamic control of laboratory indicators of hepatic samples. In the absence of normalization of transaminase in the postpartum period, an in-depth examination is carried out for the final formulation of the diagnosis, including biopsy and morphological examination of the liver tissue.

One of the exciting and the best periods In the life of each woman is her pregnancy. It is at this time in the body of a woman there are various changes in the hormonal background, and there is also a decrease in immunity.

Together, this leads to the development of various diseases and complications that affect the development of the fetus. One of the most important to determine the overall condition of a pregnant woman is a blood in which the indicators of ALT and AST are particularly attention.

Some of the leading enzymes actively involved in the development of many groups of amino acids are transaminases (alaninotransferase) and AST (aspartataminotransferase). The place of education and localization are red blood tales, as well as muscle fabrics and liver.

The detection of transaminase content by biochemical venous blood can be diagnosed in a person's organism of various complexity.

The indicators of ALT and AST differ in each other and depend on:

Patient age
Sexuality
Body masses
Lifestyle

The presence of such enzymes is also noted in the body perfectly, and the men have their number a little more than women.In the event that the increasing enhancement shows the increase in these enzymes, this may indicate the development of various diseases in the body.

For the formulation of an accurate diagnosis, specialists are conducted by repeated biochemical blood tests for several weeks, and in parallel with these anamnestic data is being taken.

In medical practice, the definition of the concentration of ALT and AST is carried out according to the results of biochemical tests.

To obtain accurate and objective information, take the best in the first half of the day.

Noram of Alt and Ast indicators has significant differences:

For women, the concentrations of enzymes up to 31 units are considered good results.
In a strong sex, the ALT indicators should not exceed 45 units / ml, and the concentration of AST should be placed within 47 units / ml.
During the indicators in the body of a woman may be contained up to 35 units / ml, and AST is up to 31 units / ml.

In the event that the indicators of these enzymes are significantly increased, this is an indicator of the progression of a person's organism of various pathologies.

End of the indicators of Alt and Ast during pregnancy

One of the basic tests during the baby tooling is. Such a study is necessarily accompanied by an assessment of enzymes - those specific proteins that take actively participating in various biochemical reactions.

Most often, the attention of experts while attracting such enzymes as:

Pancreatic alpha amylase

In the event that the studied studies diagnose the increase in this enzyme, this may indicate the development of such pathologies in the body of a pregnant woman as:

Liver liver disease
Toxicosis of pregnant women

Increased concentration of AST enzyme is observed in such organs as:

Liver
A heart
Nervous fabrics
Kidney
Spleen
Lungs
Pancreas

More information about the analysis of blood to Alt and Ast enzymes can be found from the video.

The diagnosis of minor exceeding the permissible AST indicators may cause suspicion of the development of such complications as inodianka or n's kidney atology is easy or moderate.

During the allowable content of this enzyme in the body of a woman is considered up to 31 units / ml.

In the event that the AST indicator greatly exceeds the permissible values, then experts may suspect progression in the body of a woman of such pathologies as:

Myocardial infarction
Thrombosis of pulmonary arteries
Muscle injuries of different character
Failures in the process of bile outflow
Patology of the pancreas of an acute character

Transaminases and AST are one of the important medical records, according to the results of which you can diagnose deviations in the state of health as children and adults. The increase in the content of these enzymes makes it possible to conclude about the flow of diseases of infectious diseases, various injuries and damage to organs as a result of age-related changes.

Conducting various research during the leading place among which belongs, allows us to identify pathology and prevent its further progression.

Features of Alt and Ast enzymes

Description and norm of indicators of Alt and Ast

The indicators of ALT and AST differ in each other and depend on:

Patient age
Sexuality
Body masses
Lifestyle

For the formulation of an accurate diagnosis, specialists are conducted by repeated biochemical blood tests for several weeks, and in parallel with these anamnestic data is being taken.

In medical practice, the definition of the concentration of ALT and AST is carried out according to the results of biochemical tests.

To obtain accurate and objective information, it is best to test the blood test in the first half of the day on an empty stomach.

Noram of Alt and Ast indicators has significant differences:

For women, the concentrations of enzymes up to 31 units are considered good results.
In a strong sex, the ALT indicators should not exceed 45 units / ml, and the concentration of AST should be placed within 47 units / ml.
During pregnancy, the indicators of Alt in the body of a woman may be contained up to 35 units / ml, and AST is up to 31 units / ml.

In the event that the indicators of these enzymes are significantly increased, this is an indicator of the progression of a person's organism of various pathologies.

End of the indicators of Alt and Ast during pregnancy

Deciphering the indicators of ALT and AST during pregnancy

One of the basic tests during the baby tooling is a biochemical blood test. Such a study is necessarily accompanied by an assessment of enzymes - those specific proteins that take actively participating in various biochemical reactions.

Most often, the attention of specialists during pregnancy attract such enzymes as:

In the event that the studied studies diagnose the increase in this enzyme, this may indicate the development of such pathologies in the body of a pregnant woman as:

Liver liver disease
Toxicosis of pregnant women

Increased concentration of AST enzyme is observed in such organs as:

More information about the analysis of blood to Alt and Ast enzymes can be found from the video.

Diagnosing an insignificant exceeding the permissible AST indicators may cause suspicions to develop such complications as in Odianka or the kidney atology is easy or moderate.

During pregnancy, the allowable content of this enzyme in the body of a woman is considered up to 31 units / ml.

In the event that the AST indicator greatly exceeds the permissible values, then experts may suspect progression in the body of a woman of such pathologies as:

Myocardial infarction
Thrombosis of pulmonary arteries
Muscle injuries of different character
Failures in the process of bile outflow
Patology of the pancreas of an acute character

Reducing the indicators of Alt and Ast

Conducting various studies during pregnancy, the leading place among which belongs to the biochemical analysis of blood, allows us to identify pathology and prevent its further progression.

Increased Alt during pregnancy

Maybe someone had such a situation or someone knows something about it, something can not fully trust his doctor.

All analyzes are normal, except for Alt (upgraded to 66 at a rate of up to 40). Hepatitis are negative.

He studied annotations to all drugs that I drink. In annotations to utrazhetan (still not canceled, 200 mg daily) is written during pregnancy for a long time with extreme caution, because May cause violation of liver functions. I drew the doctor's attention today to this, and she tells me "because of this can not be."

Prescribed to pass the ultrasound of the abdominal organs (liver, kidneys, bulls) and essential. Is it dangerous to do such an ultrasound during pregnancy?

Because of what could be the increase in this enzyme only?

Causes of increasing Alt and Ast during pregnancy

During the tooling of the baby, the woman's body is experiencing heavy loads, therefore it is often observed that the level of ALT and AST is raised during pregnancy. Such a phenomenon occurs even with a negative analysis for hepatitis. Different disorders in the work of the liver can be caused by its squeezing, which is enhanced as the fetus grows. When changes in biochemical analysis, it is necessary to undergo a full examination until the birth.

Causes of changing indicators in blood analysis

Up to 12 weeks, each woman is obliged to undergo a full examination, which includes blood flow to identify various diseases. The indicators of ALT and AST (Alaninotransferase and Aspartataminotransferase) show the work of the liver. Their increase may indicate the development of serious pathology, even if the symptoms are completely absent. Although at the beginning of pregnancy, the analysis is normal, the liver enzyme can increase on any time. Most often, such a phenomenon is observed at the end of the second or beginning of the third trimester.

Such a phenomenon is due to:

The pressure of the fetus on the liver, which - in turn - leads to a violation of the normal functioning of the body.
Hypersed on the body and the effects of a large number of hormones.
Taking certain medicines to preserve pregnancy.
Stast of bile due to squeezing internal organs.
The development of hepatosis against the background of the infant tool (the hepatosis of pregnant women).

Clinical manifestations

The increased indicator of ALT is usually associated with the development of liver diseases, biliary tract or intoxication of the body. Provice problems during pregnancy can an increased load on the mother's body. AST increases when taking a number of medicines, including plant origin.

Before analyzes, a pregnant woman may suspect deviations from the norm on health.

During pregnancy, a number of the following clinical manifestations may be observed:

loss of appetite,
uncharacteristic pain in the abdomen,
nausea and vomiting,

jaundice,
stool violation
weakness,
itching skin
blood coagulation disorders
dyspepsia stomach,
increased gas formation.

In the presence of such symptoms, the doctor is obliged to appoint a pregnant woman a biochemical blood test. When discovered elevated indicators, immediate treatment is required. After a while, repeated analysis for monitoring the health status of a woman is surrendered.

From excessive loads during pregnancy, the liver can declare himself at any time.

In the absence of hepatitis, assigned:

correction of the diet;
cancellation of medicines that could provoke deterioration;
droppers to maintain the work of the mother's body.

Elimination of the problem

Problems with liver or bubble may occur at any stage of the baby tooling, most often such a phenomenon occurs in late terms, when the internal organs strongly clamp the growing uterus. Increased indicators of Alt and Ast are found in women who have never suffered from diseases of internal organs.

When discovered elevated indicators, the specialist must send a woman to additional surveys to exclude:

The manifestations of gepatosis of pregnant women can enhance the reception of the vitamin complex and improper power, as well as overweight.

If there were no serious pathologies in the work of the internal organs, the specialist does the following appointments:

Power adjustment with abolition of oily, fried, decreasing animal products and an increase in plant food.
Cancellation of medicines, taking vitamins, plant herbs, which caused the deterioration of the functioning of internal organs.
Appointment of enzyme preparations, droppers.

In pathologies, not threatening the life of the mother and child, it is possible to preserve the pregnancy until the end of the term. In the later dates, the woman can get to preserve due to elevated Alt and Ast, as the state of the fetus can worsen at any time. In hepatitis, experts try to reach pregnancy to the optimal safe period to conduct an emergency delivery. Depending on the state of the mother, the method of conducting birth is selected. Since the elevated ALT and AST can lead to a violation of blood clotting, to make the cesarean operation, the cross section will be extremely dangerous, it is necessary to treat and restore coagulation.

Increased Alt and Ast during pregnancy

During pregnancy, the future mother regularly redeem analyzes and uses instrumental surveys. All diagnostic data is of great importance, since it allows you to detect pathological processes in time.

Alt and Ast are two liver enzymes that may indicate damage to this organ. If there is an increase in these substances in pregnant analyzes, you should look for the cause of this phenomenon.

Transaminase

What is this substance? Alt and Ast are enzymes from the Transaminase group. These substances produce the transfer of the amino group with the amino acid molecules on the ketokislot. Due to this reaction, the exchange of nitrogen compounds becomes associated with carbohydrate metabolism.

There are several different transaminases, but two enzymes have the greatest value:

Alaninaotransferase - Alt. This substance is involved in the metabolism of Alanine amino acids.
Aspartataminotransferase - AST. The enzyme is designed to react with aspartic acid.

Without these substances, a number of biochemical processes are impossible, so they have an important role in the body. However, in norm, most of the enzymes are inside the cells of the liver - hepatocytes. In the blood, only a small percentage of substances circulates.

In case of damage to hepatocyte, enzymes extend from the cell into the blood and the level of transfers increases.

How to determine?

Before disassembled, why Alt and Ast in pregnancy can be enhanced, it is worth knowing how these substances are determined.

For a practitioner, the doctor is important to determine the number of enzymes in peripheral (venous blood). It is for this substrate that certain norms of ALT and AST, which should not be exceeded during pregnancy.

To find out the level of enzymes, a biochemical blood test is used, it is performed several times during pregnancy. In the course of the study, the venous blood of the future mother is fees and sent to the laboratory.

In the course of biochemical research, other liver enzymes are determined, the level of total protein, the condition of carbohydrate, lipid exchanges. This study is extremely important to determine the state of the patient's internal organs.

Dumping biochemical analysis follows on an empty stomach, as some parameters can change after meals. So that the liver enzyme indicators were reliable, a few days before the delivery should not be used drugs and alcohol, although for a pregnant woman it is relevant on any toaching date.

The value is normal

The concentrations of ALT and AST may vary during life, even if the pathological process does not occur in the liver. This is due to the increased load on the organ when exposed to some factors.

During pregnancy, the level of enzymes may also change, since the liver during the tooling produces disinfecting the body not only the mother, but also the fetus.

The AST norm in the first trimester of pregnancy is less than 31 ed / l. In subsequent trimesters, the indicator is 30 units.

The norm of Alt in the first trimester is not more than 32 units. In the second and third trimester 0 less than 31.

These indicators are averaged and can be seriously varied in different laboratories. Equipment for a specific diagnostic department can seriously differ and the analysis rate will be changed. Therefore, it is important to pay attention to reference values \u200b\u200bon the for analysis.

If AST and Alt are raised during pregnancy, it should not be included in the panic. During the hatching, transient jumps of enzymes are possible due to the effect of the fetus on the liver of a future mother.

Causes of raising

Nevertheless, if Alt or AST is elevated according to the results of several analyzes, it is recommended to identify the cause of this state.

The increase in transaminase is one of the criteria for special syndrome - cytolysis. This term means the death of the liver cells, which is characteristic of some organ disease.

Both outside and during pregnancy, the causes of cytolysis can be:

The effects of medicinal substances - medicinal hepatitis.
Viral damage to the organ.
The inflammation of the gallbladder is cholecystitis.
Autoimmune hepatitis.
Liver cirrhosis - do not always lead to an increase in transaminase.

For pregnancy, two more pathological conditions are special - yellow liver atrophy in the first trimension of pregnancy and preeclampicia (old name - late toxicosis).

It is not always easy to determine the specific reason. The doctor should take into account the anamnesis data, the clinical picture of the disease. For additional diagnostics, a number of analyzes and instrumental studies are carried out.

Medicinal hepatitis

The liver is an extremely susceptible organ for the effects of various medicinal substances. During pregnancy, the load on it increases and the influence of even small doses of drugs can cause a toxic effect.

Most pregnant women get the minimum amount of drugs during none, as doctors try to avoid adverse effects on the fruit. However, it is sometimes impossible to avoid the appointment of medicines.

The following drugs can cause hepatocyte death:

Antibiotics of various groups. Even permissible macrolides are able to seriously affect liver cells and cause hepatitis.
Preparations for the treatment of tuberculosis - these drugs are also sometimes prescribed during pregnancy.
Hormonal agents, including preparations for the treatment of familiar miscarriage.
Nonteroidal anti-inflammatory funds. In pregnancy, only aspirin can be used, but it is capable of affecting the liver cells.
Anticonvulsant and anti-epileptic drugs.
Medicines for the treatment of fungal infections.
Diuretics (diuretic) - in some cases are prescribed pregnant.
Antiarrhythmic agents.
Medicines from diabetes - must be canceled during pregnancy with the transition to insulin.

Similar mechanism of influence on the liver has alcohol. It also causes toxic liver damage and the release of Alt and Ast. However, the reception of alcoholic beverages is contraindicated during toasting.

Viral hepatitis

There is a group of viruses that have a special property to affect liver cells. These microorganisms are called hepatitis A, B, C, E, D, and other, more rare species.

Hepatitis A virus can cause only an acute inflammatory process, it leads to severe symptoms and cannot but notice a pregnant woman. Sometimes such severe disease leads to the interruption of pregnancy.

But hepatitis B, C and E viruses are able to cause both acute and chronic process. Chronic viral hepatitis can flow almost asymptomatic and the only sign of the disease in this case will increase the transaminase.

Hepatitis E virus during pregnancy is most dangerous. This microorganism violates the development of the baby and very often leads to miscarriage.

To make a diagnosis, a serological examination of blood is prescribed to identify viruse markers. Detection of antibodies or genetic material of pathogens allows you to diagnose with a point and begin treatment.

Cholecystitis

Bile disease worries a huge number of people of different ages. It is the presence of stones in the bile ways most often becomes the cause of cholecystitis. This disease is characterized by inflammation of the wall of the gallbladder.

Promotes the exacerbation of the disease in pregnant women:

Reducing the immune forces of the future mother.
Elevated bile viscosity.
Increasing intra-abdominal pressure.
Change the level of hormonal background.

As a result of these factors, the stones clog the lumen of the bubble and cause inflammation of its wall.

Acute cholecystitis is a surgical disease. He has a bright clinical picture. The patient is delivered to the surgical hospital where the gynecologist and the surgeon jointly determine the tactics of treatment.

Chronic cholecystitis can proceed with unfinished symptoms. Light gravity in the right side, changing the chair, nausea may not disturb the pregnant woman. But in the biochemical analysis of blood, the increase in hepatic enzymes is often detected.

Autimmune hepatitis

During pregnancy, the risk of exacerbation of any diseases of immunity increases. The protective system of the mother is seriously rebuilt to get used to the presence of an additional source of alien proteins - the child's body.

This factor may cause autoimmune hepatitis manifestation. The disease is quite rare. With this pathology there is a certain genetic defect that causes the woman's immune cells to attack their own hepatocytes. Liver cells are dying and released transferases. The level of Alt and AST in the blood increases seriously.

The peculiarity of the disease is the preempty debut of about 20-30 years, and this period is most favorable for pregnancy and childbirth. Therefore, with raising transfers in a pregnant woman and the absence of data for other diseases, do not forget about autoimmune hepatitis.

Confirm the diagnosis helps specific studies on disease markers. Treatment of the disease is not an easy and makes it difficult for pregnancy.

Beep fatty dystrophy

Early toxicosis of pregnant women is a fairly common condition. It is usually manifested by nausea and vomiting, which many consider to be a mandatory satellite of pregnancy.

More rare forms of toxicosis are salivation, cramps, dermatoses, osteomalacia, bronchial asthma and, finally, yellow liver atrophy.

Yellow liver atrophy is more often a consequence of severe vomiting and dehydration. Extremely rarely, this form of toxicosis is manifested by itself.

Under the influence of hormonal changes, the exchange of metabolism in hepatocytes occurs.
Inside the liver cell begins fat rebirth.
The size of the organ decreases.
Enhances the level of enzymes due to the death of cells.
Bilirubin rises and jaundice arises.
The liver cannot perform blood disinfecting, nerve disorders and coma occur.
The process occurs very quickly - for 3 weeks.

This rare complication requires interruption of pregnancy, but changes in the liver can be irreversible.

Preeclampsia

In the second half of pregnancy, toxicosis can not be. However, preeclampsia or prostosis is a fairly common complication.

The disease is characterized by a number of changes:

The blood pressure increases.
Renal tubules begin to skip a protein that stands out with urine.
Embanks arise.
The function of the nervous system and other organs is disturbed.

The liver in this pathology also suffers seriously. Jaundice occurs, the disinfecting function of the liver is disturbed, the bloodstream suffers through the organ.

Even in the absence of clinical manifestations, to push the doctor to the idea of \u200b\u200bthe impending preeclampsia may change in the analysis. Damage to hepatic cells leads to increasing transaminases.

Damage to the liver does not always occur at this condition, but if the woman was diagnosed with preeclampsia, the increase in Alt and AST is not surprised.

What to do?

The future mother is important to know not only the causes of changes in blood tests, but also further tactics.

First of all, data from biochemical research should be discussed with your doctor a gynecologist. The specialist will prompt the norms of indicators in a particular laboratory and, if necessary, prescribe a repeated analysis.

Further diagnostic search will be carried out by a specialist:

With the help of laboratory and instrumental research, the doctor will reveal the reason for increasing enzymes.
Specific treatment will be prescribed, which in some cases is carried out in the hospital.
The question of the possibility of prolongation of pregnancy and the method of roostening is solved.

Do not worry before receiving the most complete information about your health. Many reasons for increasing transaminases are successfully treated and does not cause complications for the fetus.

Increase the indicators of Alt and Ast during pregnancy

AST and Alt are endogenous enzymes that are synthesized intracellularly and their limited quantity comes into the blood. If Alt and Ast are raised during pregnancy, it usually indicates the presence of serious pathological processes that do not ride a threat to the life of a woman, and the development of the child. To keep in the normal transaminase indicators, it is necessary to pass surveys from a doctor once every two weeks, and donate blood according to the scheduled schedule.

Analysis

Future moms throughout the pregnancy are forced to undergo surveys and constantly pass tests. It is necessary that the doctor can clearly control the course of pregnancy and determine anything early stages. One of the most important procedures is a biochemical blood test. It includes many indicators, each of which carries certain information about the state of the internal organs.

The procedure is required for an empty stomach, it is forbidden to drink coffee, as well as gas. During the day before the pregnant procedure, it is necessary to abandon sweet, oily and canned food. Dinner on the eve should be easy and consisting of either vegetable salad or from a dairy porridge.

In the course of the study, venous blood is made in the number and poisoned into the laboratory. The procedure is low-break, but some women can cause dizziness. A woman tied up with a hand with a harness so that the peripheral vein was clearly species, and the doctor could pierce her from the first time. Further, the skin on the hand is disinfected and puncture a special syringe. The resulting biomaterial is sent to the laboratory study, and the woman stick to the leukoplaster into the place of the puncture and send home.

The results of the analysis, as a rule, do not wait long, because the blood is examined immediately, otherwise, it begins to turn around and is lost a certain number of indicators. Deciphering analysis can be obtained the next day. The laboratories use different equipment, so sometimes the norms of the norm at the same pregnant woman may differ depending on the location of the diagnosis.

In addition to the planned survey, the testimony for the passage of analysis to the level of AST and Alt may become characteristic symptoms, such as:

increased protein in the urine;
increased blood pressure;
swelling feet and hands;
jaundice;
elevated bilirubin in general blood test;
frequent belching;
feeling of bitterness in the mouth;
pain in the hypochondrium;
frequent dizziness;
pain in the chest;
loss of appetite;
sword;
increased fatigue;
discomfort in the stomach;
changing the color of feces and urine;
nausea and vomit urge in the late months of pregnancy.

Most of the above symptoms are familiar to pregnancy, so the grooms are in no hurry to report them to the doctor, which significantly complicates the formulation of the diagnosis and accordingly delays treatment. If you want to make a healthy baby, even the slightest change in the usual state should be a reason for turning to the doctor. Tightening with advice, you consciously provoke the development of a serious illness. Deciphering the results, as well as the selection of corrective therapy, should be engaged only by a qualified specialist. Self-diagnosis and self-treatment are categorically prohibited, because they can cause fetus fetal and miscarriage.

AST and Alt - what is it?

AST Alt is contained in a variety of human organs - in kidneys, liver, heart, as well as in skeletal muscles. The main functions of Alt AST is the synthesis of amino acid, and directly alanine, which turns into glucose. It is she who is the main source of energy for the human body. While the Number of Alt and Ast is preserved in the body, the number of human blood enzymes is minimally, but when the structure of the cells listed above is disturbed, then the oscillation of the protein enzyme is. The larger the body is damaged, the higher the content of AST and Alt during pregnancy.

If Alt and Ast are raised during pregnancy, it is usually associated with changes in the liver, which can provoke complications such as preeclampsia, cholestasis of pregnant women and acute liver dystrophy. The largest amount of Alanine Minotransferase is in the liver, so the change in the activity of the enzyme is the first sign of the pathology of this particular body. Aspartataminotransferase can be detected by damage to the heart muscle. If simultaneously donate the analysis on Alt and Ast, it is possible to calculate the coefficient de ritis, it is normal equal to 1.33. In the event of a liver disease, it is lower than this value, in the presence of heart pathology, the indicator will be higher.

Alt elevated during pregnancy may be due to the fact that the liver of a woman simply does not cope with the task set for it because of the heavy load. Alat and asat, which differ from the norm may be provoked by the disadvantage of vitamin B6. Another possible causes provoking the increase in Alt and AST during pregnancy is cirrhosis and hepatitis.

Hepatitis E is particularly dangerous, he in most cases leads to miscarriage. Forms B, C, and may proceed at all asymptomatic, and the only indicator of their presence will be the level of transamilase.

Diagnose these pathologies on the basis of the level of alaninotransferase and the Aspartatenotransferase indicator cannot be carried out, it is necessary to carry out additional analyzes - liver samples, as well as ultrasound liver surveys.

Normal indicators and causes

During pregnancy, the AST value is up to 31-33 w / ml, Alt-to 31st / l. If an AST is raised, in addition to the above pregnancy complications, it can be provoked:

closed heart injuries;
autoimmune infections;
toxic lesion of liver with medication drugs;
purily septic diseases of internal organs;
cholestasy;
impaired hepatic blood flow;
malignant tumors and metastases.

It is required to note that not all elevated in pregnant women are alarming from doctors. If the difference from the norm leaves only a few units - this is the option of the norm, anxiety causes a condition when AST increases in 5 and more times.

The highest indicator of the Alt in the blood speaks of a heart attack if the indicator is increased 20 times, then he is more hepatitis or pancreatitis. In pregnant women, jumps of transamilase indicators can cause excessive exercise stress, Frequent use of fast food, stretching muscles, emotional shocks, as well as infectious diseases. If a woman has passed shortly before delivery, for example, catheterization or another procedure, which disrupts the integrity of the skin, in the blood of the high indicators of the enzymes of this group may be occurred.

Separately, it is important to note the use of drugs during the toaling of the baby. The fact is that the liver is very susceptible in the process of pregnancy, and the slightest toxic impact on it can cause the death of its cells and such a disease as cytolysis. Among the drugs that more than others are able to disrupt the integrity of the body and cause an increase in the indicators of AST and Alt, it can be noted:

antibiotics, even allowed during pregnancy macrolides, can seriously damage the body and cause hepatitis;
preparations for the treatment of tuberculosis, which is sometimes prescribed during pregnancy;
hormonal agents that can be assigned to prevent miscarriage;
non-steroidal anti-inflammatory agents, even aspirin may affect liver cells;
anticonvulsant and anti-epileptic medicines;
antifungal drugs;
diuretics, which are prescribed pregnant women to normalize the work of the kidneys;
especially harmful medications from diabetes, they must be canceled during pregnancy, the woman is temporarily transferred to insulin.

Features of treatment

If the indicators of AST and Alt are overestimated - this indicates the destruction of cells of a certain organ, so you need to seriously deal with its treatment. It is impossible to lower the drugs by drugs, it can make it an exceptionally correct lifestyle and timely therapy of disturbing symptoms. Remember that high performance in the normal state of health are not, and AST, Alt is not the cause of the ailment, but its consequence.

The task of the patient is the timely definition of symptoms and appeal to the doctor, and the task of the doctor is the correct formulation of diagnosis and therapy, which does not harm the mother and child. It is required to note that the method of therapy is individual, as the age of mother, the term of pregnancy is taken into account, and of course, the reasons for increasing blood enzymes.

The jumps of protein enzymes are not a reason to resolve pregnancy by cesarean cross section. Most women give birth to naturally. The exception will be acute hepatitis and cirrhosis, which can in the process of becoming the cause of the liver break, as well as heart failure, which can trigger the lethal outcome and mother, and the child.

During pregnancy, not only hormonal changes occurs, the load is experiencing the entire body, so it is necessary to relate very seriously to the planned inspections of the doctor. The liver and heart during pregnancy are forced to work with a double strength to maintain the viability of two organisms. At this time, it is necessary for them to take care and care, adjusting their nutrition, as well as protecting themselves from loads.

Pregnancy is a period that should be remembered by a woman with positive moments, and not infinite interruption in the doctor's office. That is why, plan a pregnancy in advance, and you warn unpleasant surprises during baby tooling, such as hepatitis, renal failure and disorders of the heart muscle. All these diseases are easily determined using instrumental diagnostic methods and are applied. Adhere to all the recommendations of the doctor during pregnancy, and you can give birth to a healthy baby.

Norms of Alt and Ast during pregnancy

Why give the blood test to the child

During the 1st and 2nd trimesters of pregnancy, the level of Alt in the blood can decrease by 5-10%, and in the 3rd trimester - fully corresponds to the norm.

The norm of Alt in the blood is 0.1 - 0.78 μKat / L.

The reasons for the increase in Alt in the blood during pregnancy are the same as outside it.

The false increase in AST during pregnancy may occur as a result of the hemolysis of the erythrocytes, i.e. Isolation of the erythrocyte fraction of AST.

Gamma-GlutamilTransferase

Alkaline phosphatase

Alkaline phosphatase rate of 0.7-2.1? Kat / L. In the third trimester can reach 4.2? Kat / L.

Common Bilirubin

The norm of a common bilirubin in blood is 3.4 - 17,1? MOL / L.

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Norm Alt and Ast in Blood

When the decoding is made, the norm of the indicators of Alt is considered digit mol / (C L) and 0.10-0.69 μmol / (ml h).

If the blood test is performed using an optical test, then at 30 ° C, the norm will be 2-25 months, the child will be changed.

The child Alt should not have more than 50 units per liter, and AST is 55 units per liter (up to 9 years). The newborn child AST will persist at the level of 140 units per liter (up to 5 days).

Causes of increasing Alt.

After the decryption of the data is completed, it can be found that the ALT increases not only for diseases of the liver, but also with problems with other organs. However, most often precisely the disease of the heart and liver lead to an increase in this indicator. A list of diseases for which Alt is elevated, such: cirrhosis, tumor education in the liver, jaundice, dystrophy fat in the liver, hepatitis, motion of cells, pancreatitis, liver problems during pregnancy, liver damage due to toxicological lesions, some infectious diseases, myopathy, Myocardial infarction, myocarditis, bone fractures, muscle breaks. Some substances and drugs also lead to the fact that Alt rises.

The reasons for the decline of Alt.

Treatment of elevated levels of Alt and Ast

It is necessary to properly organize a healthy diet. It is important to use a large number of vegetables and fruits, the brown rice will be extremely useful. These products contain fiber. In addition, you should drink green tea or any herbal teas. They will help not only clean the liver, but also lead to the normal water balance of the whole organism. Very well helps tea from dandelion, burdock, milk thistle. Be sure to take products that contain a high level of vitamin C. You can drink the medicine rises. For every kilogram of weight you need to drink at least 30 ml of pure water (not juices, drinks and tea). Respiratory exercises help well. It is important to exercise in the morning or play sports.

K +, Na +, Cl-, Mg, P, Fe