Increased ast and alt during pregnancy. What is ALT during pregnancy. Normal ALT during pregnancy. Increased ALT during pregnancy Bad asat effect on the fetus
What are ALT and AST, what is the norm for pregnant women with these parameters, how to determine their level? So called marker enzymes for the liver, myocardium, lungs, kidneys, pancreas. If you decipher the abbreviations, you get the following - alanine aminotransferase and aspartate aminotransferase. In the presence of these transaminases in the blood, the functioning of organs is disrupted, due to the fact that cell destruction occurs. An increase in these enzymes indicates the development of a complex disease. When considering the results of a blood test, it turns out where the focus is.
The norm in pregnant women
When carrying a child, a woman's body experiences various changes - starting with the hormonal background and ending with the work of all organ systems. Therefore, the indicators of any tests may differ from those performed before the conception of the child. What is the normal level of ALT and AST in pregnant women? In healthy pregnant women, the ALT indicator will be considered normal with data in the region of 31 units / ml.
This enzyme can be found in the following organs:
- liver;
- kidneys;
- heart muscles;
- spleen;
- pancreas;
- lungs.
If there is a violation in the process of functioning of these cells, they massively enter the bloodstream.
This process indicates the development of:
- hepatitis A;
- hepatosis;
- liver damage;
- inflammatory process in the pancreas;
- heart or kidney disease.
Pregnant women may experience an increase in ALT levels in the third trimester. This contributes to the appearance of late toxicosis. AST has similar results that are considered acceptable for pregnant women. This enzyme should be up to 31 units/ml.
An increase is possible:
- with heart disease;
- with liver pathologies.
Both enzymes can exceed the permissible parameters when various diseases appear. Most often they are associated with problems of the blood, liver, heart, overweight. If this level is elevated at the very beginning of pregnancy, there is no cause for concern.
Why ALT and AST levels may rise
What is the norm of ALT and AST, because of which the level of transaminases increases? In pregnant women, ALT and AST may exceed the norm, but this phenomenon is temporary. If the parameters do not return to normal, then this indicates the development of pathology.
In other cases, the reasons for the increase may include the following:
- The number of enzymes can increase with various changes in the liver tissues. The reason may be the development of hepatitis. In this case, the patient develops a yellow skin tone, pain in the right hypochondrium, and the abdomen swells. This will be accompanied by an increase in bilirubin. By indicators of the level of enzymes, one can judge the stage of development of the disease.
- Myocardial infarction can cause the death of heart muscle cells. There is a release of enzymes into the blood, the patient will feel pain in the region of the heart and the entire left side of the body. The session will last approximately 30 minutes. There will be shortness of breath, general weakness, dizziness and a feeling of fear.
- Indicators can exceed the norm for various heart problems. If the disease is chronic, there is a steady increase in the level of AST and ALT in the blood. The pressure will be reduced, the patient will have difficulty breathing.
- An elevated level of enzymes in the blood can be detected after an injury. This is facilitated by burns or severe wounds.
- The development of pancreatitis will be accompanied by an increase in enzymes in the blood. Pain in the abdomen, weight loss and disruption of the intestines also accompany changes in blood parameters.
It is not worth excluding health problems during the period of bearing a child. Therefore, if the level of AST and ALT is exceeded, you need to do a blood test and find out the true cause of the changes in parameters.
Liver tests
During pregnancy, liver tests are required for the expectant mother. This is done once every 38 weeks. This procedure consists in conducting a blood test in order to identify any pathological processes.
Features of such tests in pregnant women:
- The readings may differ from those taken before pregnancy.
- Bearing a child can cause the manifestation of chronic diseases, their exacerbation. In some cases, pregnancy can provoke the development of complications.
- After the birth of the baby, the test results return to normal if their change was associated only with this process.
- Quite rarely, future childbirth 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 conduct a blood test for expectant mothers.
It is mandatory to check the level:
- GGT (gamma-glutamyl transpeptidase);
- alkaline phosphatase;
- bilirubin.
It is recommended to contact the antenatal clinic in the early stages of pregnancy in order to undergo the necessary examination in time and identify deviations from the norm. A blood test will detect any changes in the functioning of the body and the development of the fetus.
Dynamics of ALT and AST readings and the significance of the analysis
How does ALT and AST differ during pregnancy from the norm? Alanine aminotransferase is located in the liver cells, and any changes in its tissues provoke an increase in the level of the enzyme. By determining this specific marker, complex diseases are identified.
How ALT levels change during normal pregnancy:
- In the 1st trimester there is an increase of 5 to 10%.
- In the 2nd trimester, an increase of 5 to 10% may occur.
- In the 3rd trimester, the indicators should return to normal.
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 organ. And during pregnancy, a false increase can occur due to the destruction of red blood cells.
AST level by trimesters:
- In the first trimester there is a decrease of 5 to 10%.
- In the second trimester, there is a decrease in the level from 5 to 10%.
- In the third trimester, the level returns to normal.
There is one feature - after childbirth, the level of AST may increase directly due to labor activity.
An increase in the level of AST and ALT enzymes can warn of the onset of the development of the disease.
For example, in case of a heart attack, ALT levels will be 150% higher than normal, AST results will exceed almost 500%. With the onset of hepatitis, according to the tests, it can be detected as early as 2 weeks before the onset of obvious symptoms. This refers to the A or B virus. This will allow timely treatment, and the recovery period will take a little more than a month.
Based on the results of such tests, health problems during pregnancy can be identified and the necessary measures can be taken. Treatment occurs with the use of drugs and adherence to a special diet. If there are no indications for the operation, labor is carried out naturally.
Therefore, it is necessary to undergo preventive examinations and be observed by a doctor throughout the entire period of pregnancy.
All women who can bear offspring need:
- Plan to have a child.
- Pre-pass a medical examination.
- If any signs of deviation appear in the test results, establish the true cause.
- Try to avoid infection with any viruses.
- Follow all doctor's recommendations.
AST and ALT levels may change 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 delivery or abortion for medical reasons.
ALT
Alanine aminotransferase or ALT- This is an enzyme that is located 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.
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 it is completely normal.
The norm of ALT in the blood 0.1 - 0.78 µkat/l.
The reasons for the increase in ALT in the blood during pregnancy are the same as outside it.
AST
Aspartate aminotransferase or AST present in the liver, myocardium, muscles, kidneys, pancreas and erythrocytes. AST is available in two forms - mitochondrial (70%) and cytoplasmic (30%). The release of cytoplasmic AST, which is less, occurs with moderate liver damage. And mitochondrial (which is 2.5 times more) is released with more severe destruction and the achievement of a pathological process to mitochondria.
A false increase in AST during pregnancy can occur as a result of hemolysis of red blood cells, i.e. isolation of the erythrocyte fraction of AST.
The norm of AST in the blood 0.60 ?cat/l.
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 it should be completely normal. After childbirth, AST can grow due to active muscular labor activity.
Gamma-glutamyltransferase
Gamma—glutamyltransferase or GGT grows with cholestasis - impaired movement of bile through the biliary tract. GGT decreases in the 1st and 3rd trimesters of pregnancy, and in the second it may increase slightly. In acute and exacerbation of chronic liver diseases, GGT increases.
GGT norm in blood 0.14–0.68 ?kat/l.
Alkaline phosphatase
Alkaline phosphatase or AP increases with diseases of the liver and bones. ALP in adults is more indicative of hepatic cholestasis in pregnant women. The values of alkaline phosphatase in the blood of pregnant women change with each trimester. In the first third, it may decrease, and in the second and third, it will grow. In the second - by a third of the norm, in the third - an increase of up to 2 times.
The norm of alkaline phosphatase in the blood 0.7-2.1 ?kat/l. In the third trimester, it can normally reach 4.2 ?kat/l.
total bilirubin
Bilirubin formed during the metabolism of hemoglobin. Excreted by the liver. In the blood of pregnant women, bilirubin in the first or second trimester can decrease by 30-100%, and in the third - by 10-30%. If a pregnant woman has an elevated level of bilirubin in the results of liver tests, you should immediately consult a doctor to determine the cause. The most likely exacerbation of chronic liver disease or infection with viral hepatitis.
The norm of total bilirubin in the blood 3.4 - 17.1 mol/l.
Related newsSubmitted People@_mama_2014, November 25, 2013 · 16,953 Views Girls, hello everyone!
Maybe someone had such a situation or someone knows something about it, something I can’t fully trust my doctor.
All tests are normal, except for ALT (increased to 66 at a rate of up to 40). Hepatitis is negative.
I studied the annotations for all the drugs that I drink. In the annotation to utrozhestan (still not canceled, 200 mg daily) it is written during pregnancy for a long time with extreme caution, because. may cause liver dysfunction. I drew the attention of the doctor today to this, and she says to me, “Because of this, it cannot be.”
She prescribed an ultrasound scan of the abdominal organs (liver, kidneys, gallbladder) and Essentiale. Is it dangerous to do such an ultrasound during pregnancy?
Because of what there can be an increase only in this enzyme?
ALT in the blood
What does ALT in the blood show?
Alanine aminotransferase, or ALT for short, is a special endogenous enzyme. It is included in the transferase group and the aminotransferase subgroup. The synthesis of this enzyme takes place intracellularly. A limited amount enters the bloodstream. Therefore, when a biochemical analysis shows an increased content of ALT, this indicates the presence of a number of abnormalities in the body and the development of serious diseases. Often they are associated with the destruction of organs, which leads to a sharp release of the enzyme into the blood. As a result, the activity of alanine aminotransferase is also enhanced. It is difficult to establish the extent of necrosis or the degree of tissue damage based on this, since the enzyme is not characterized by organ specificity.
Alanine aminotransferase is found in many human organs: kidneys, heart muscle, liver, and even skeletal muscles. The main function of an enzyme is to exchange amino acids. It acts as a catalyst for the reversible transfer of alanine from the amino acid to alpha-ketoglutarate. As a result of the transfer of the amino group, glutamic and pyruvic acids are obtained. Alanine in the tissues of the human body is necessary, as it is an amino acid that can quickly turn into glucose. Thus, it is possible to obtain energy for the functioning of the brain and central nervous system. In addition, among the important functions of alanine is the strengthening of the body's immune system, the production of lymphocytes, and the regulation of the metabolism of acids and sugars.
The highest activity of alanine aminotransferase was found in the blood serum of men. In women, processes involving the enzyme proceed more slowly. The highest concentration is noted in the kidneys and liver, followed by skeletal muscles, spleen, pancreas, erythrocytes, lungs, heart.
What is analysis used for?
The largest amount of transferase was found in the liver. This observation is used to detect diseases of this organ that do not have external symptoms. ALT, unlike many other components considered in the biochemical analysis of blood, has been studied most fully. Therefore, it can be used to identify even minor problems in the body. In some cases, the amount of ALT is compared with the amount of other elements in the blood. This allows you to draw conclusions about the presence of pathologies.
For example, an enzyme such as aspartate aminotransferase or AST is often used. It is also synthesized intracellularly, and a limited amount enters the bloodstream. Deviation from the standard established in medicine for the content of aspartate aminotransferase, as in the case of alanine aminotransferase, is a manifestation of deviations in the work of some organs. The most complete picture of the nature of the pathology allows you to get the correlation of the contained amount of both enzymes. If there is an excess of alanine aminotransferase over aspartate aminotransferase, this indicates the destruction of liver cells. The level of AST rises sharply in the later stages of the disease of this organ, such as cirrhosis. When the level of aspartate aminotransferase exceeds the content of alanine aminotransferase, problems with the heart muscle are observed.
Additional diagnostic methods allow to confirm the presence of the disease and the degree of organ damage. However, ALT is an accurate indicator; in some cases, it can even be used to establish the stage of the disease and suggest possible options for its development.
When is an ALT test ordered?
The amount of alanine aminotransferase in liver problems helps to identify them even before the appearance of the most characteristic symptom - jaundice. Therefore, the doctor prescribes an analysis for ALT most often in order to check for damage to this important organ as a result of taking medications or any other substances that are toxic to the body. Also, the study is carried out with suspicion of hepatitis. ALT analysis is mandatory in the presence of symptoms such as increased fatigue and weakness of the patient. He loses his appetite, often feels nausea, turning into vomiting. Yellow spots on the skin, pain and discomfort in the abdomen, yellowing of the whites of the eyes, light-colored stools and dark urine can all be signs of liver disease. In such cases, this analysis is required.
ALT can be compared with AST for more information on the causes of liver damage. This is done if the number of enzymes significantly exceeds the norm. The ratio of AST to ALT is known in medicine as the de Ritis ratio. Its normal value ranges from 0.91 to 1.75. If this indicator becomes more than 2, then damage to the heart muscle is diagnosed, which occurs with the destruction of cardiomyocytes. Myocardial infarction is also possible. The de Ritis coefficient, not exceeding 1, indicates liver disease. Moreover, the lower the value of the indicator, the greater the risk of an adverse outcome.
ALT analysis can be used not only as a diagnostic method, but also during treatment. This allows you to determine the dynamics of the course of the disease and identify improvements or deterioration in the patient's condition. An ALT test is necessary if factors contributing to liver disease are present. These include the abuse of alcoholic beverages or drugs that destroy the cells of the body. If the normal amount of alanine aminotransferase in the blood is exceeded, other drugs are prescribed. It is imperative to check the amount of ALT if the patient has been in contact with patients with hepatitis or has recently had it himself, has diabetes and is overweight. Some people are predisposed to liver disease. They are also shown an analysis for ALT.
When it is carried out, either venous or capillary blood is used. In order to obtain reliable results, certain requirements must be met. First, do not eat 12 hours before the date and do not drink alcohol for a week. Even a small amount of food can make a big difference. Secondly, within half an hour before the analysis, stop smoking, do not worry, avoid moral and physical overstrain. Results are usually ready a day after delivery.
The norm of ALT in the blood in men and women
The amount of the enzyme alanine aminotransferase in the blood is measured in units per liter.
Depending on the gender and age of the patient, its value ranges from 0 to 50:
In newborns up to 5 days of age, ALT should not exceed 49 U / l.
For children up to six months, this figure is higher - 56 U / l.
At the age of six months to a year, the amount of ALT in the blood can reach 54 U / l
From one to three - 33, but gradually the normal amount of the enzyme in the blood decreases
In children from 3 to 6 years old, its upper limit is 29 U / l.
In children, minor deviations from the norm are allowed. This is due to uneven growth. Over time, the amount of enzyme in the blood should stabilize and approach normal.
the upper limit of the indicator is 40 U / l.
But the results of the analysis for ALT are often far from the established norms. This may be due not only to the presence of inflammatory processes in the body, but also to other factors. Elevated levels of alanine aminotransferase can be triggered by taking aspirin, warfarin, paracetamol and oral contraceptives in women. Therefore, the doctor should be aware of the use of such drugs before testing for ALT. Medicines based on valerian and echination have a similar effect. Unreliable test results may be caused by increased motor activity or intramuscular injections.
Did you find a mistake in the text? Select it (a few words!) and press Ctrl + Enter - Inaccurate recipe? - Write to us about it, we will definitely clarify it from the source! - Something else? - write to us, we will clarify the information!
ALT elevated in the blood
The amount of alanine aminotransferase in the blood is considered elevated if it exceeds the established norm, especially by tens, and in some cases hundreds of times. Depending on this, the presence of the disease is determined. With an increase in the level of ALT by 5 times, myocardial infarction can be diagnosed, if it reaches 10-15 times, we can talk about the deterioration of the patient's condition after an attack. The value of the de Ritis coefficient in this case also changes upwards.
Hepatitis provokes an increase in the content of the enzyme in the blood by 20-50 times, muscular dystrophy and dermatomyasitis - by 8. Gangrene, acute pancreatitis is indicated by an excess of the upper limit of the indicator by 3-5 times.
It is possible not only to increase the content of alanine aminotransferase in the blood. Its too low amount is associated with a lack of the B6 organism, which is part of this enzyme, or with complex inflammatory processes in the liver.
What does an increase in ALT mean?
An increase in ALT indicates the course of inflammatory processes in the body. They can be caused by the following diseases:
This inflammatory liver disease can present in several forms. For chronic or viral hepatitis, the excess of the level of alanine aminotransferase in the blood is insignificant. In hepatitis A, ALT analysis makes it possible to detect the infection in advance. The amount of enzyme in the blood increases a week before the first external manifestations of the disease appear in the form of jaundice. Viral or alcoholic hepatitis is accompanied by a pronounced increase in ALT levels.
This malignant tumor is often formed in patients with hepatitis. Analysis for ALT in this case is necessary both for diagnosing the disease and for making a decision on the surgical decision. When the level of alanine aminotransferase significantly exceeds the norm, surgical intervention may not be possible, since the risk of various complications is high.
The presence of this disease is also indicated by the level of ALT. Its increased amount indicates an exacerbation of pancreatitis. Patients with this diagnosis will have to be periodically tested for ALT throughout their lives. This will help to avoid attacks of the disease and monitor the progress of treatment.
It manifests itself in lesions of the heart muscle. Its main symptoms are shortness of breath, rapid fatigue of the patient and an increased content of ALT in the blood. To diagnose this disease, the level of AST is determined, and then the de Ritis coefficient is calculated.
This disease is dangerous because for a long time it may not have pronounced symptoms. Patients quickly get tired, feel tired. Less often there are pains in the area of a liver. In this case, cirrhosis can be determined by the elevated content of ALT in the blood. The amount of enzyme in the blood can exceed the norm by 5 times.
This disease is a consequence of impaired blood flow, resulting in necrosis of the tissues of the heart muscle. In the case of an uncomplicated myocardial infarction, the level of ALT rises slightly compared to AST, however, it can be used to determine an attack.
Reasons for the increase in ALT
Taking a number of medicinal or herbal preparations - barbiturates, statins, antibiotics;
frequent use of fast food before taking an analysis for ALT;
drinking alcohol less than a week before blood sampling;
non-compliance with the basic rules for the delivery of analysis, including the sterility of the procedure;
increased emotional or physical stress;
carrying out shortly before the analysis of catheterization of the heart muscle or other surgical intervention;
steatosis - a disease that manifests itself in the accumulation of fat cells in the liver, most often occurs in overweight people;
- K+, Na+, Cl-, Mg, P, Fe
Norms of indicators of a biochemical blood test during pregnancy
Bilirubin is a blood pigment formed as a result of the breakdown of hemoglobin, a change in the concentration of which is directly related to the state of the liver and spleen.
There are two types of bilirubin (fractions): direct (or bound) and indirect (free or not bound), and their sum gives a quantitative estimate of total bilirubin in human blood. The norm of indirect bilirubin is 3.4-13.7 µmol/l, and direct bilirubin is 0-7.9 µmol/l. Then the normative content of total bilirubin in the blood is in the range of 3.4-21.6 µmol/l.
As a rule, total and direct bilirubin are displayed in the results of a biochemical blood test, and their difference, respectively, will be the amount of indirect bilirubin in human blood.
For diagnostic purposes, the level of bilirubin is useful in determining jaundice, liver disease, cholestasis, hemolytic anemia, infectious mononucleosis. In these diseases, there is an increase in both direct and indirect bilirubin.
During pregnancy, there is often an increase in indirect bilirubin with normal readings of hemoglobin, ALT, AST, GGT and direct bilirubin, as well as good ultrasound of the liver and gallbladder. There is nothing to worry about, this phenomenon is called Gilbert's syndrome - this is a congenital disease that persists throughout life and does not pose a risk to the development of the child.
It is recommended to take Essentiale forte 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, drinking a few sips of water) for for 10 days to help your liver cope with the load, as well as adhere to proper nutrition, you can’t starve!
Alanine transaminase or alanine aminotransferase (ALT or ALT)- an intracellular enzyme, which is found to a greater extent in the liver and kidneys, in a smaller amount - in the heart muscle, lungs, pancreas and spleen.
The norm of the ALT enzyme in the blood of a woman is up to 31 U / ml.
When the cells of these organs are destroyed, a significant release of ALT into the blood is observed, which happens with hepatitis, fatty liver hepatosis, jaundice, toxic liver damage, pancreatitis, heart disease and other serious diseases.
With late toxicosis (gestosis) during pregnancy, there may be a slight increase in ALT.
Aspartate aminotransferase (AST)- an enzyme that, like ALT, is involved in the metabolism of amino acids and is found in the cells of various human organs.
The norm of AST in the blood in women is up to 31 U / ml.
An increase in the level of this enzyme most often indicates problems with the heart (in particular, with the myocardium), as well as liver diseases.
There are hepatic reasons for the increase in ALT and AST - liver ischemia, viral hepatitis, liver hepatosis, and non-hepatic reasons - hemolytic anemia (hemolysis), obesity, etc.
A slight increase in ALT and AST enzymes in the first and second trimester of pregnancy is not a consequence of the disease.
Creatinine is a product of the metabolism of creatine phosphate, which is involved in the process of providing human muscles with energy.
Creatinine is filtered in the kidneys, and in the event of a violation of their work, an increase in createnin in the human blood is observed.
The normative concentration of creatinine in the blood of a woman is 53-97 µmol / l.
During pregnancy (usually in the 1st and 2nd trimesters), there is a decrease in this indicator by 40% due to an increase in blood volume, enhanced by the work of the kidneys, i.e. the content of creatinine during pregnancy decreases to 35-70 µmol/l, which is physiologically normal.
If a pregnant woman is too thin or if a vegetarian diet is followed, this indicator can also be reduced, which in this case is not a good sign, it is necessary to gain weight by adjusting and balancing nutrition.
Urea is a nitrogen-containing product, which, along with creatinine, makes it clear how the excretory system of the kidneys works.
Cholesterol (or cholesterol)- this is an important building component of the cells of our body, most of which is produced in the liver, the rest - a person receives with food. Cholesterol is also involved in the production of sex hormones, so monitoring cholesterol levels and keeping it normal is an important task during the period of bearing a child.
Cholesterol norms according to the woman's age, mmol / l: With normal general blood counts, a two-fold increase in cholesterol during pregnancy is the norm, that is, each indicator in this table must be multiplied by 2. This increase is due to the active release of certain hormones into the woman's blood necessary for the formation of the placenta .
An increase in cholesterol (namely, on average, with indications of more than 12-13 mmol / l) is observed in liver diseases, cholestasis, pancreatitis, renal failure, coronary heart disease, diabetes mellitus, obesity, etc.
Both for the baby and for the mother, elevated cholesterol is an extremely undesirable phenomenon, therefore, it is necessary to take measures to reduce it: change the diet to a lower calorie one, do exercises for pregnant women, etc.
Indeed, with an excess of cholesterol, the risk of intrauterine anomalies in the development of the cardiovascular system in the fetus increases, and the mother herself may suffer from a decrease in the strength of blood vessels, their blockage and the formation of blood clots, with a deficiency, the risk of spontaneous miscarriage or premature birth increases, and in a pregnant woman with reduced cholesterol, deterioration in well-being.
Glucose It is the main blood marker for determining diabetes mellitus in humans. The norm of blood glucose is 3.89-5.83 mmol / l, but during pregnancy in healthy women this indicator is often reduced, because the fetus grows and needs more glucose, which it consumes from the mother's body.
Also, during the period of bearing a child, pregnant women experience gestational diabetes mellitus, which disappears after childbirth. These phenomena are considered within the normal range, since they are caused by the active release of glucose by the mother's body and its consumption by the developing fetus.
An increase in blood glucose indicates diabetes mellitus, kidney and liver diseases, pancreatitis.
A decrease in glucose can also be with endocrine pathologies, for example, with adrenal insufficiency.
Diastase (or alpha-amylase)- an enzyme that is synthesized in the pancreas and salivary glands, is present in small amounts in the liver and intestines, so this blood marker is used primarily to diagnose pancreatic diseases and inflammatory processes in the salivary glands, and of course to confirm liver diseases and gastrointestinal tract.
The norm for an adult is 25-125 U / l.
An increase in the level of diastasis in the blood is observed with pancreatitis, cholecystitis, renal failure, diabetes mellitus, etc.
And a decrease in the level of diastasis - with toxicosis, hepatitis, pancreatic insufficiency.
Gamma-glutamyl transferase or gamma-glutamyl transpeptidase (GGT (GGTP) or GGTP) is an enzyme that accumulates in the kidneys, liver and pancreas.
The norm of GGT for women is up to 36 U / ml.
During the second trimester of pregnancy, GGT may be slightly increased, which is within the normal range.
In diseases of the liver and biliary system (cholestasis, for example), there is a significant increase in the enzyme in the blood serum. GGT can also increase in diabetes mellitus.
Alkaline phosphatase (AP)- an enzyme mainly involved in the growth of bone tissue.
The norm of alkaline phosphatase in women is 40-150 U / ml. An increase in this enzyme during fracture healing is considered normal.
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 the fetal bone tissue.
Also, an increase in alkaline phosphatase may indicate the presence of a disease of the bones or liver (for example, with hepatic cholestasis, hepatitis).
Also, with infectious mononucleosis, an increase in alkaline phosphatase is observed in the first week of the disease.
Taking antibiotics, magnesia, large doses of vitamin C, insufficient intake of foods 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)- These are the main inorganic substances that play an important role in the work of the whole organism. Each of them is responsible for certain important processes: for muscle contractions, conduction of nerve impulses, metabolism in the human body, for maintaining somatic pressure, maintaining acid-base balance, functioning of the nervous system, oxygen transfer, etc.
Both an increase and a decrease in the content of macro- and microelements in the body of a pregnant woman leads to health problems for both the mother and the unborn child, so it is important to maintain these indicators in the normal range by taking specially designed vitamin and mineral complexes for pregnant women.
A biochemical blood test should be taken only in the morning and on an empty stomach, and the last meal should be 8-12 hours before the test.
In contact with
Material from the site zaletela.net.
Together, this leads to the development of various diseases and complications that affect the development of the fetus. One of the important tests to determine the general condition of a pregnant woman is a biochemical blood test, in which special attention is paid to ALT and AST.
Features of ALT and AST enzymes
Description and norm of ALT and AST indicators
One of the leading enzymes actively involved in the production of many groups of amino acids are transaminases ALT (alanine aminotransferase) and AST (aspartate aminotransferase). The place of formation and localization of AST are red blood cells, as well as muscle tissue and the liver.
Indicators of ALT and AST differ from each other and depend on:
- Patient's age
- Gender
- body weight
- Lifestyle
The presence of such enzymes is also noted in the body of a perfectly healthy person, and in men their number is slightly higher than in women. In the event that the conducted studies show an increase in these enzymes, this may indicate the development of various diseases in the body.
To make an accurate diagnosis, specialists conduct repeated biochemical blood tests for several weeks, and in parallel with these, anamnestic data are collected.
In medical practice, the determination 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 take a blood test in the first half of the day on an empty stomach.
The norms of ALT and AST indicators have significant differences:
- For women, enzyme concentrations up to 31 U / ml are considered good results.
- In the stronger sex, ALT values should not exceed 45 U / ml, and the concentration of AST should be within 47 U / ml.
- During pregnancy, ALT levels in a woman's body can be up to 35 U / ml, and AST - up to 31 U / ml.
In the event that the indicators of these enzymes are significantly increased, then this is an indicator of the progression of various pathologies in the human body.
Elevated ALT and AST levels during pregnancy
Deciphering ALT and AST indicators during pregnancy
One of the main tests during the bearing of a baby is a biochemical blood test. Such a study is necessarily accompanied by an assessment of enzymes - those specific proteins that are actively involved in various biochemical reactions.
Most often, the attention of specialists during pregnancy is attracted by enzymes such as:
ALT takes an active part in metabolic processes, and a large amount of it is found in the liver and kidneys. During pregnancy, the acceptable content of ALT in the body is up to 35 U / ml.
In the event that the studies carried out diagnose an increase in this enzyme, then this may indicate the development in the body of a pregnant woman of such pathologies as:
- Liver diseases of various nature
- Toxicosis of pregnant women
An increased concentration of the AST enzyme is observed in organs such as:
More information about the blood test for ALT and AST enzymes can be found in the video.
Diagnosing a slight excess of the permissible AST levels may raise suspicions for the development of complications such as edema or kidney pathology of mild or moderate severity.
During pregnancy, the content of this enzyme in a woman's body is considered to be up to 31 U / ml.
In the event that the AST indicator greatly exceeds the permissible values, then specialists may suspect the progression in the woman's body of such pathologies as:
- myocardial infarction
- Thrombosis of the pulmonary arteries
- Muscle injuries of various nature
- Failures in the process of outflow of bile
- Pathologies of the pancreas of an acute nature
Decrease in ALT and AST
ALT and AST transaminases are one of the important medical indicators, the results of which can be used to diagnose deviations in the health status of both children and adults. An increase in the content of these enzymes allows us to draw a conclusion about the course of infectious diseases in the human body, various injuries and damage to organs as a result of age-related changes.
The process of reducing the elevated concentration of ALT and AST in the human body can proceed independently and it begins immediately after the elimination of the main causes that caused the development of the underlying disease.
Conducting various studies during pregnancy, the leading place among which belongs to a biochemical blood test, allows you to identify the pathology in time and prevent its further progression.
Elevated ALT during pregnancy
Maybe someone had such a situation or someone knows something about it, something I can’t fully trust my doctor.
All tests are normal, except for ALT (increased to 66 at a rate of up to 40). Hepatitis is negative.
I studied the annotations for all the drugs that I drink. In the annotation to utrozhestan (still not canceled, 200 mg daily) it is written during pregnancy for a long time with extreme caution, because. may cause liver dysfunction. I drew the attention of the doctor today to this, and she says to me, "Because of this, it cannot be."
She prescribed an ultrasound scan of the abdominal organs (liver, kidneys, gallbladder) and Essentiale. Is it dangerous to do such an ultrasound during pregnancy?
Because of what there can be an increase only in this enzyme?
Reasons for increasing ALT and AST during pregnancy
During the bearing of the baby, the woman's body is under great stress, so it is often observed that the level of ALT and AST is increased during pregnancy. This phenomenon occurs even with a negative analysis for hepatitis. Various disorders in the liver can be caused by its compression, which increases as the fetus grows. If changes are detected in the biochemical analysis, it is required to undergo a complete examination before the moment of delivery.
Causes of changes in indicators in the blood test
Up to 12 weeks, every woman is required to undergo a complete examination, which includes blood donation to identify various diseases. Indicators of ALT and AST (alanine aminotransferase and aspartate aminotransferase) show the work of the liver. Their increase may indicate the development of a serious pathology, even if the symptoms are completely absent. Although the analysis is normal at the beginning of pregnancy, the liver enzyme can increase at any time. Most often, this phenomenon occurs at the end of the second or beginning of the third trimester.
This phenomenon is due to:
- The pressure of the fetus on the liver, which - in turn - leads to disruption of the normal functioning of the organ.
- Increased load on the body and exposure to a large number of hormones.
- Taking certain medications to keep the pregnancy going.
- Stagnation of bile due to compression of internal organs.
- The development of hepatosis against the background of bearing a baby (hepatosis of pregnant women).
Clinical manifestations
Elevated ALT is usually associated with the development of diseases of the liver, biliary tract, or intoxication of the body. An increased load on the mother's body can provoke problems during pregnancy. AST increases when taking a number of medications, including those of plant origin.
Before the tests, a pregnant woman may suspect deviations from the norm for health reasons.
During pregnancy, a number of the following clinical manifestations can be observed:
- loss of appetite,
- uncharacteristic pain in the abdomen,
- nausea and vomiting,
- jaundice,
- stool disorder,
- weakness,
- itching of the skin,
- blood clotting disorders,
- stomach dyspepsia,
- increased gas production.
In the presence of such symptoms, the doctor is obliged to prescribe a biochemical blood test to the pregnant woman. If elevated levels are detected, immediate treatment is required. After some time, a second analysis is given to monitor the woman's health status.
From excessive stress during pregnancy, the liver can declare itself at any time.
In the absence of hepatitis are prescribed:
- diet correction;
- the abolition of drugs that could provoke a deterioration in the condition;
- droppers to support the work of the mother's body.
Troubleshooting
Problems with the liver or gallbladder can occur at any stage of bearing a baby, most often this phenomenon occurs in the later stages, when the internal organs are strongly clamped by the growing uterus. Elevated levels of ALT and AST are found in women who have never suffered from diseases of the internal organs.
If elevated rates are detected, the specialist should send the woman for additional examinations to exclude:
Manifestations of hepatosis in pregnant women can increase the intake of the vitamin complex and malnutrition, as well as overweight.
If no serious pathologies in the work of internal organs have been identified, then the specialist makes the following appointments:
- Adjustment of nutrition with the abolition of fatty, fried foods, a decrease in animal products and an increase in plant foods.
- Cancellation of medicines, taking vitamins, herbal herbs, which caused a deterioration in the functioning of internal organs.
- Appointment of enzymatic preparations, droppers.
With pathologies that do not threaten the life of the mother and child, it is possible to maintain the pregnancy until the end of the term. In the later stages, a woman can get into preservation due to elevated ALT and AST, since the condition of the fetus can worsen at any time. With hepatitis, specialists try to hold out the pregnancy until the optimal safe period in order to carry out an emergency delivery. Depending on the condition of the mother, the method of delivery is chosen. Since elevated ALT and AST can lead to impaired blood clotting, doing a caesarean section will be extremely dangerous, first you need to treat and restore clotting.
Elevated ALT and AST during pregnancy
During pregnancy, the expectant mother regularly takes tests and undergoes instrumental examinations. All diagnostic data are of great importance, since they allow timely detection of pathological processes.
ALT and AST are two liver enzymes that may indicate liver damage. If an increase in these substances is found in the analyzes of a pregnant woman, the cause of this phenomenon should be sought.
Transaminases
What are these substances? ALT and AST are enzymes from the group of transaminases. These substances transfer the amino group from the amino acid molecule to the keto acid. Thanks to this reaction, the exchange of nitrogenous compounds becomes associated with carbohydrate metabolism.
There are several different transaminases, but two of the most important are:
- Alanine aminotransferase - ALT. This substance is involved in the metabolism of the amino acid alanine.
- Aspartate aminotransferase - AST. The enzyme is designed to react with aspartic acid.
Without these substances, a number of biochemical processes are impossible, so they play an important role in the body. However, normally most of the enzymes are located inside the liver cells - hepatocytes. Only a small percentage of substances circulate in the blood.
When a hepatocyte is damaged, enzymes leave the cell into the blood and the level of transferases increases.
How to determine?
Before analyzing why ALT and AST can be elevated during pregnancy, it is worth knowing how these substances are determined.
For a practitioner, it is important to determine the amount of enzymes in the peripheral (venous blood). It is for this substrate that certain ALT and AST standards have been established, 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. During the study, the venous blood of the expectant mother is taken and sent to the laboratory.
In the course of a biochemical study, other liver enzymes, the level of total protein, the state of carbohydrate and lipid metabolism are also determined. This study is extremely important to determine the condition of the internal organs of the patient.
Biochemical analysis should be taken in the morning on an empty stomach, as some parameters may change after eating. In order for the liver enzymes to be reliable, a few days before the delivery, you should not use drugs and alcohol, although this is true for a pregnant woman at any gestation period.
Value is OK
The concentrations of ALT and AST can change throughout life, even if the pathological process in the liver does not occur. This is due to the increased load on the body when exposed to certain factors.
During pregnancy, the level of enzymes can also change, since the liver during gestation detoxifies the body of not only the mother, but also the fetus.
The norm of AST in the first trimester of pregnancy is less than 31 U / l. In subsequent trimesters, the indicator is 30 units.
The ALT norm in the first trimester is no more than 32 units / l. In the second and third trimester, 0 is less than 31.
These indicators are averaged and can vary greatly in different laboratories. The equipment of a particular diagnostic department may seriously differ and the norm of analyzes will be changed. Therefore, it is important to pay attention to the reference values on the test form.
If AST and ALT are elevated during pregnancy, you should not panic. During gestation, transient jumps in enzymes are possible due to the influence of the fetus on the liver of the expectant mother.
Reasons for the increase
However, if ALT or AST is elevated on several tests, it is recommended to identify the cause of this condition.
An increase in transaminases is one of the criteria for a special syndrome - cytolysis. This term means the death of liver cells, which is characteristic of some diseases of the organ.
Both outside and during pregnancy, the causes of cytolysis can be:
- Drug exposure – drug-induced hepatitis.
- Viral damage to the body.
- Inflammation of the gallbladder - cholecystitis.
- autoimmune hepatitis.
- Cirrhosis of the liver - does not always lead to an increase in transaminases.
For pregnancy, two more pathological conditions are special - yellow liver atrophy in the first trimester of pregnancy and preeclampsia (the old name is late toxicosis).
Determining a specific cause is not always easy. The doctor should take into account the data of the anamnesis, the clinical picture of the disease. For additional diagnostics, a number of analyzes and instrumental studies are carried out.
drug-induced hepatitis
The liver is an extremely susceptible organ to the effects of various drugs. During pregnancy, the load on it increases and the influence of even small doses of drugs can cause a toxic effect.
Most pregnant women receive a minimal amount of medication during pregnancy, as doctors try to avoid adverse effects on the fetus. However, sometimes it is impossible to avoid prescribing medications.
The following drugs can cause the death of hepatocytes:
- Antibiotics of various groups. Even macrolides allowed during pregnancy can seriously damage liver cells and cause hepatitis.
- Tuberculosis drugs - These drugs are also sometimes prescribed during pregnancy.
- Hormonal drugs, including drugs for the treatment of recurrent miscarriage.
- Non-steroidal anti-inflammatory drugs. During pregnancy, only aspirin can be used, but it can also affect liver cells.
- Anticonvulsants and antiepileptic drugs.
- Medicines to treat fungal infections.
- Diuretics (diuretics) - in some cases, are prescribed to a pregnant woman.
- Antiarrhythmic drugs.
- Medications for diabetes - should be canceled during pregnancy with the transition to insulin.
Alcohol has a similar mechanism of influence on the liver. It also causes liver toxicity and release of ALT and AST. However, the intake of alcoholic beverages is contraindicated during gestation.
Viral hepatitis
There is a group of viruses that have a special property to infect liver cells. These microorganisms are called hepatitis A, B, C, E, D viruses and other rarer types.
The hepatitis A virus can only cause an acute inflammatory process, this leads to severe symptoms and cannot be overlooked by a pregnant woman. Sometimes such a serious illness leads to termination of pregnancy.
But hepatitis B, C and E viruses can cause both acute and chronic process. Chronic viral hepatitis can be almost asymptomatic and the only sign of the disease in this case will be an increase in transaminases.
The hepatitis E virus is the most dangerous during pregnancy. This microorganism disrupts the development of the baby and very often leads to miscarriage.
To make a diagnosis, a serological blood test is prescribed to identify virus markers. Detection of antibodies or genetic material of pathogens makes it possible to make a diagnosis with a point and start treatment.
Cholecystitis
Gallstone disease worries a huge number of people of different ages. It is the presence of stones in the bile ducts that most often causes cholecystitis. This disease is characterized by inflammation of the gallbladder wall.
Contributes to the exacerbation of the disease in pregnant women:
- Decrease in the immune forces of the expectant mother.
- Increased viscosity of bile.
- Increase in intra-abdominal pressure.
- Changes in hormonal levels.
As a result of these factors, the stones clog the lumen of the bladder and cause inflammation of its wall.
Acute cholecystitis is a surgical disease. He has a vivid clinical picture. The patient is taken to the surgical hospital, where the gynecologist and the surgeon jointly determine the tactics of treatment.
Chronic cholecystitis can occur with unexpressed symptoms. A slight heaviness in the right side, a change in stool, nausea may not bother a pregnant woman. But in a biochemical blood test, an increase in liver enzymes is often found.
autoimmune hepatitis
During pregnancy, the risk of exacerbation of any diseases of the immune system increases. The mother's defense system is seriously rebuilt in order to get used to the presence of an additional source of foreign proteins - the child's body.
This factor can cause the manifestation of autoimmune hepatitis. The disease is quite rare. With this pathology, there is a certain genetic defect that causes the woman's immune cells to attack her own hepatocytes. Liver cells die and transferases are released. The level of ALT and AST in the blood is seriously increased.
A feature of the disease is considered to be the predominant age of onset of about 20-30 years, and this period is the most favorable for pregnancy and childbirth. Therefore, with an increase in transferases in a pregnant woman and the absence of data for other diseases, one should not forget about autoimmune hepatitis.
Specific studies on markers of the disease help to confirm the diagnosis. Treatment of the disease is not easy and complicates the course of pregnancy.
Fatty degeneration of the liver
Early toxicosis of pregnant women is a fairly common condition. Usually it is manifested by nausea and vomiting, which many consider to be an obligatory companion of pregnancy.
More rare forms of toxicosis are salivation, convulsions, dermatoses, osteomalacia, bronchial asthma and, finally, yellow liver atrophy.
Yellow liver atrophy is more often the result of severe vomiting and dehydration. It is extremely rare that this form of toxicosis manifests itself.
- Under the influence of hormonal changes, there is a change in the metabolism in hepatocytes.
- Fatty degeneration begins inside the liver cells.
- The size of the organ is reduced.
- The level of enzymes increases due to cell death.
- Bilirubin rises and jaundice occurs.
- The liver cannot perform blood detoxification, nervous disorders and coma occur.
- The process is very fast - within 3 weeks.
This rare complication requires termination of pregnancy, but changes in the liver may be irreversible.
Preeclampsia
In the second half of pregnancy, there can be no toxicosis. However, a fairly common late complication is preeclampsia or preeclampsia.
The disease is characterized by a number of changes:
- The blood pressure rises.
- The renal tubules begin to pass the protein that is excreted in the urine.
- Edema occurs.
- The function of the nervous system and other organs is impaired.
The liver in this pathology is also seriously affected. Jaundice occurs, the detoxification function of the liver is disturbed, and blood flow through the organ suffers.
Even in the absence of clinical manifestations, changes in the analyzes can lead the doctor to the idea of impending preeclampsia. Damage to liver cells leads to an increase in transaminases.
Liver damage in this condition does not always occur, but if a woman has been diagnosed with preeclampsia, it is not surprising to increase ALT and AST.
What to do?
It is important for the expectant mother to know not only the reasons for the change in blood tests, but also further tactics.
First of all, the data of the biochemical study should be discussed with your gynecologist. The specialist will tell you the norms of indicators in a particular laboratory and, if necessary, prescribe a second analysis.
Further diagnostic search will be carried out by a specialist:
- With the help of laboratory and instrumental studies, the doctor will identify the cause of the increase in enzymes.
- A specific treatment for the disease will be prescribed, which in some cases is carried out in a hospital.
- The issue of the possibility of prolonging pregnancy and the method of delivery is being resolved.
Do not worry until you get the most complete information about your health. Many causes of elevated transaminases are successfully treated and do not cause complications for the fetus.
Increase in ALT and AST levels during pregnancy
Ast and Alt are endogenous enzymes that are synthesized intracellularly and a limited amount of them enters the bloodstream. If alt and ast are elevated during pregnancy, then this, as a rule, indicates the presence of serious pathological processes that do not pose a threat to the life of the woman and the development of the child. To keep transaminase levels normal, it is necessary to undergo examinations by a doctor every two weeks, and donate blood according to the established schedule.
Conducting an analysis
Expectant mothers throughout pregnancy are forced to undergo examinations and constantly take tests. This is necessary so that the doctor can clearly monitor the course of pregnancy and determine what is wrong in the early stages. One of the most important procedures is a biochemical blood test. It consists of many indicators, each of which carries certain information about the state of internal organs.
The procedure is necessarily carried out on an empty stomach, it is forbidden to drink coffee, as well as soda. A day before the procedure, a pregnant woman must refuse sweet, fatty and canned food. Dinner the day before should be light and consist of either vegetable salad or milk porridge.
During the study, venous blood is withdrawn in the amount of ml and poisoned to the laboratory. The procedure is not painful, but may cause dizziness in some women. A woman's hand is bandaged with a tourniquet so that the peripheral vein is clearly visible, and the doctor can pierce it the first time. Next, the skin on the arm is disinfected and a puncture is made with a special syringe. The resulting biomaterial is sent for laboratory testing, and the woman is glued with a band-aid to the puncture site and sent home.
The results of the analysis, as a rule, do not have to wait long, since the blood is examined immediately, otherwise, it begins to clot and a certain number of indicators are lost. A transcript of the analysis can be obtained the very next day. Laboratories use different equipment, so sometimes the normal values for the same pregnant woman may differ depending on the place of diagnosis.
In addition to a routine examination, an indication for undergoing an analysis for the level of ast and alt may be characteristic symptoms, such as:
- increased protein in the urine;
- high blood pressure;
- swelling of the legs and arms;
- jaundice;
- elevated bilirubin in the general blood test;
- frequent belching;
- feeling of bitterness in the mouth;
- pain in the hypochondrium;
- frequent dizziness;
- chest pain;
- loss of appetite;
- shortness of breath;
- increased fatigue;
- abdominal discomfort;
- discoloration of feces and urine;
- nausea and vomiting in the later months of pregnancy.
Most of the above symptoms are habitual for pregnancy, so women are in no hurry to report them to the doctor, which significantly complicates the diagnosis and, accordingly, delays the treatment. If you want to bear a healthy baby, even the slightest change in the usual state should be a reason to see a doctor. By delaying the consultation, you are deliberately provoking the development of a serious illness. The interpretation of the results, as well as the selection of corrective therapy, should be carried out exclusively by a qualified specialist. Self-diagnosis and self-treatment are strictly prohibited, because they can cause fetal fading and miscarriage.
AST and ALT - what is it?
Ast alt is found in many human organs - in the kidneys, liver, heart, as well as in skeletal muscles. The main functions of alt ast is the synthesis of amino acids, and directly alanine, which is converted into glucose. It is she who is the main source of energy for the human body. As long as the norm of alt and ast is maintained in the body, the number of enzymes in human blood is minimal, but when the structure of the cells of the above organs is disturbed, the protein enzyme fluctuates. The more the organ is damaged, the higher the content of ast and alt during pregnancy.
If alt and ast are elevated during pregnancy, then this is usually associated with changes in the liver, which can provoke complications such as preeclampsia, cholestasis of pregnancy and acute fatty degeneration of the liver. The largest amount of alanine minotransferase is located in the liver, so a change in enzyme activity is the first sign of the pathology of this particular organ. Aspartate aminotransferase can be detected in lesions of the heart muscle. If you simultaneously take an analysis for alt and ast, you can calculate the de Ritis coefficient, it is normally equal to 1.33. In the case of liver disease, it is below this value, in the presence of heart pathology, the indicator will be higher.
Alt increased during pregnancy may be due to the fact that the woman's liver simply does not cope with the task assigned to it due to the heavy load. Alat and asat, which differ from the norm, can be triggered by a lack of vitamin B6. Another of the possible causes that provoke an increase in alt and ast during pregnancy is cirrhosis and hepatitis.
Hepatitis E is especially dangerous, in most cases it leads to miscarriage. Forms B, C, A can be completely asymptomatic, and the only indicator of their presence will be the level of transamylase.
It is impossible to diagnose these pathologies based on the level of alanine aminotransferase and aspartate aminotransferase, it is necessary to conduct additional tests - liver tests, as well as ultrasound examination of the liver.
Indicators of the norm and reasons for the difference
During pregnancy, the rate of ast is up to 31-33 U / ml, alt-up to 31 U / l. If ast is elevated, in addition to the above complications of pregnancy, it can be triggered by:
- closed injuries of the heart;
- autoimmune infections;
- toxic damage to the liver with medications;
- purulent-septic diseases of internal organs;
- cholestasis;
- violations of the hepatic blood flow;
- malignant tumors and metastases.
It should be noted that not all elevated rates in pregnant women are alarming for doctors. If the difference from the norm leaves only a few units - this is a variant of the norm, the state when the ast rises by 5 or more times causes concern.
The highest indicator of alt in the blood indicates a heart attack, if the indicator is increased by 20 times, then it is rather hepatitis or pancreatitis. In pregnant women, jumps in transamylase levels can be caused by excessive exercise, frequent consumption of fast food, muscle strain, emotional upheaval, and infectious diseases. If a woman, shortly before the delivery, underwent, for example, catheterization or another procedure that violates the integrity of the skin, high levels of enzymes of this group may be noted in the blood.
Separately, it is important to note the use of medications during the bearing of the baby. The fact is that the liver is very susceptible during pregnancy, and the slightest toxic effect on it can cause the death of its cells and a disease such as cytolysis. Among the drugs that are most capable of violating the integrity of the organ and causing an increase in ast and alt, it can be noted:
- antibiotics, even macrolides allowed during pregnancy, can seriously damage the organ and cause hepatitis;
- drugs for the treatment of tuberculosis, which are sometimes prescribed during pregnancy;
- hormonal agents that may be prescribed to prevent miscarriages;
- non-steroidal anti-inflammatory drugs, even aspirin can affect liver cells;
- anticonvulsant and antiepileptic drugs;
- antifungal drugs;
- diuretics, which are prescribed to pregnant women to normalize kidney function;
- drugs for diabetes are especially harmful, 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 the cells of a certain organ, so you need to seriously deal with its treatment. It is impossible to lower the indicators by medication; this can only be done by the right lifestyle and timely treatment of anxiety symptoms. Remember that there are no high rates in a normal state of health, and ast, alt is not the cause of the disease, but already its consequence.
The task of the patient is the timely identification of symptoms and contacting a doctor, and the task of the doctor is the correct diagnosis and therapy, which does not harm the mother and child. It should be noted that the method of therapy is individual, since the age of the mother, the duration of pregnancy and, of course, the reasons for the increase in enzymes in the blood are taken into account.
A jump in protein enzymes is not a reason to resolve a pregnancy by caesarean section. Most women give birth naturally. An exception would be acute hepatitis and cirrhosis, which can cause liver rupture during attempts, as well as heart failure, which can cause death for both mother and child.
During pregnancy, not only hormonal changes occur, the whole body experiences a load, so it is necessary to take routine examinations with a doctor very seriously. The liver and heart during pregnancy are forced to work with a vengeance to maintain the viability of the two organisms. At this time, they need to be cared for and cared for by adjusting their diet, as well as protecting themselves from stress.
Pregnancy is a period that a woman should remember with positive moments, and not with endless interruptions in the doctor's office. That is why, plan your pregnancy in advance, and you will prevent unpleasant surprises during the gestation of the baby, such as hepatitis, kidney failure and disruption of the heart muscle. All these diseases are easily determined using instrumental diagnostic methods and are treated. Follow all the doctor's recommendations during pregnancy, and you can give birth to a healthy baby.
ALT and AST norms during pregnancy
Alanine aminotransferase or ALT is an enzyme that is located 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 take a blood test for a 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 it is completely normal.
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.
Aspartate aminotransferase or AST is present in the liver, myocardium, muscles, kidneys, pancreas, and red blood cells. AST is available in two forms - mitochondrial (70%) and cytoplasmic (30%). The release of cytoplasmic AST, which is less, occurs with moderate liver damage. And mitochondrial (which is 2.5 times more) is released with more severe destruction and the achievement of a pathological process to mitochondria.
A false increase in AST during pregnancy can occur as a result of hemolysis of red blood cells, 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 it should be completely normal. After childbirth, AST can grow due to active muscular labor activity.
Gamma-glutamyltransferase
Gamma-glutamyltransferase, or GGT, rises in cholestasis, an impaired flow of bile through the biliary tract. GGT decreases in the 1st and 3rd trimesters of pregnancy, and in the second it may increase slightly. In acute and exacerbation of chronic liver diseases, GGT increases.
Alkaline phosphatase
Alkaline phosphatase or alkaline phosphatase is elevated in diseases of the liver and bones. ALP in adults is more indicative of hepatic cholestasis in pregnant women. The values of alkaline phosphatase in the blood of pregnant women change with each trimester. In the first third, it may decrease, and in the second and third, it will grow. In the second - by a third of the norm, in the third - an increase of up to 2 times.
The rate of alkaline phosphatase in the blood is 0.7-2.1 ?kat/l. In the third trimester, it can normally reach 4.2 ?kat/l.
total bilirubin
Bilirubin is formed in the process of hemoglobin metabolism. Excreted by the liver. In the blood of pregnant women, bilirubin in the first or second trimester may decrease by %, and in the third - by 10-30%. If a pregnant woman has an elevated level of bilirubin in the results of liver tests, you should immediately consult a doctor to determine the cause. The most likely exacerbation of chronic liver disease or infection with viral hepatitis.
The norm of total bilirubin in the blood is 3.4 - 17.1 mol / l.
Related news
- increase in body temperature.
IGOR MIRZOYAN AND ENSEMBLE
The norm of ALT and AST in the blood
Biochemical examination allows you to determine violations in the work of many organs, including the liver and heart. AST shows abnormalities in the functioning of the heart, and ALT - in the functioning of the liver. If the level is elevated, what does this mean? Which indicators of these parameters are considered the norm, and which deviations?
When the decoding is done, the norm of ALT indicators is considered tsinmol / (s l) and 0.10-0.69 µmol / (ml h).
For the AST indicator, the norm will be nmol / (s l) or 0.10 - 0.46 μmol / (ml h). These are indicators that are taken into account in the Frenkel and Reitman method, 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 IU, the indicator will be changed in the child.
The strongest increases in ALT occur with liver disease. This is especially true for hepatitis. If processes of cirrhosis of the liver are observed, then the AST indicator will exceed the ATL indicator.
If a blood test showed that AST was increased two or more times, then this may indicate the presence of a myocardial infarction. If AST is first elevated, and then it decreases after 4 days, then most likely there was no heart attack.
A child should not have ALT more than 50 units per liter, and AST - 55 units per liter (up to 9 years). In a newborn baby, AST will remain at 140 units per liter (up to 5 days).
Reasons for the increase in ALT
After the decoding of the data is completed, it can be found that ALT rises not only with liver diseases, but also with problems with other organs. However, most often it is heart and liver diseases that lead to an increase in this indicator. The list of diseases for which ALT is elevated is as follows: cirrhosis, tumors in the liver, jaundice, fatty liver, hepatitis, cell death, pancreatitis, liver problems during pregnancy, liver damage due to toxicological damage, certain infectious diseases, myopathy, myocardial infarction, myocarditis, bone fractures, muscle ruptures. Some substances and drugs also cause ALT to rise.
Reasons for the decrease in ALT
After the decoding of biochemistry has been carried out, it can be found that in some diseases the level of ALT may decrease. Oddly enough, but the decrease in the level of ALT is most often not associated with the work of the liver. Such diseases include infectious infection of the genitourinary system, tumor neoplasms in various places of the human body, hepatitis (alcoholic), B6 deficiency due to improper diet or too frequent use of alcoholic beverages.
Treatment of elevated ALT and AST levels
To reduce ALT and AST, you need to understand the parameters of the analysis. If the decoding of the analysis in the blood shows deviations, then this will indicate the presence of a particular disease in the body. To lower the level of ALT and AST, you must first remove the source of the disease, due to which there was an increase in the levels of ALT and AST in the blood.
It is necessary to properly organize a healthy diet. It is important to consume a large number of vegetables and fruits, brown rice will be extremely useful. These foods contain fiber. In addition, you should drink green tea or any herbal teas. They will help not only cleanse the liver, but also normalize the water balance of the whole organism. Tea from dandelion, burdock, milk thistle helps very well. Be sure to take foods that contain high levels of vitamin C. You can drink Revit medicine. For every kilogram of weight you need to drink at least 30 ml of pure water (not juices, drinks and tea). Breathing exercises help a lot. It is important to exercise in the morning or play sports.
It must be remembered that treatment should not be carried out to improve the parameters of the data in the blood test, but in order for the sick person to recover. The doctor should first of all think not about lowering the indicators, but about how to determine the focus of the disease and remove all inflammatory processes. Then the indicators will return to normal.
Given that ATL is elevated only when liver cells are damaged, the doctor must prescribe not only drugs for the treatment of damaged organs, but also those drugs that are called hematoprotectors. They make it possible to protect hepatocytes from the influence of other aggressive factors.
In addition, any doctor must remember that the liver is weakened during this period, it cannot be put at risk, because it can be even more damaged, therefore drugs that have a toxic effect on the liver are strictly prohibited. In other words, you can not use drugs that can cause liver cells to die even faster.
The best hepatoprotectors are those that are developed on a plant basis. These include hepabene, Essentiale H, legalon, tykveol, carsil. These medicines have a positive effect on the liver. First, they protect cells from further damage. Secondly, they have the ability to restore liver cells, that is, those cells that are damaged, but have not yet died, can be restored through the use of these drugs. In addition, they do not have a toxic effect on other organs. These drugs take on some of the functions of the liver, that is, they can perform a secretory function, participate in metabolism, and also perform a disinfecting function, partially destroying toxins in the body of the victim.
- K+, Na+, Cl-, Mg, P, Fe
Norms of indicators of a biochemical blood test during pregnancy
Bilirubin is a blood pigment formed as a result of the breakdown of hemoglobin, the change in the concentration of which is directly related to the state of the liver and spleen.
There are two types of bilirubin (fractions): direct (or bound) and indirect (free or not bound), and their sum gives a quantitative estimate of total bilirubin in human blood. The norm of indirect bilirubin is 3.4-13.7 μmol / l, and direct - 0-7.9 μmol / l. Then the normative content of total bilirubin in the blood is in the range of 3.4-21.6 µmol/l.
As a rule, total and direct bilirubin are displayed in the results of a biochemical blood test, and their difference, respectively, will be the amount of indirect bilirubin in human blood.
For diagnostic purposes, the level of bilirubin is useful in determining jaundice, liver disease, cholestasis, hemolytic anemia, infectious mononucleosis. In these diseases, there is an increase in both direct and indirect bilirubin.
During pregnancy, there is often an increase in indirect bilirubin with normal readings of hemoglobin, ALT, AST, GGT and direct bilirubin, as well as good ultrasound of the liver and gallbladder. There is nothing to worry about, this phenomenon is called Gilbert's syndrome - this is a congenital disease that persists throughout life and does not pose a risk to the development of the child.
It is recommended to take Essentiale forte 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, drinking a few sips of water) for for 10 days to help your liver cope with the load, as well as adhere to proper nutrition, you can’t starve!
Alanine transaminase or alanine aminotransferase (ALT or ALT) is an intracellular enzyme that is found to a greater extent in the liver and kidneys, and to a lesser extent in the heart muscle, lungs, pancreas and spleen.
The norm of the ALT enzyme in the blood of a woman is up to 31 U / ml.
When the cells of these organs are destroyed, a significant release of ALT into the blood is observed, which happens with hepatitis, fatty liver hepatosis, jaundice, toxic liver damage, pancreatitis, heart disease and other serious diseases.
With late toxicosis (gestosis) during pregnancy, there may be a slight increase in ALT.
Aspartate aminotransferase (AST) is an enzyme that, like ALT, is involved in the metabolism of amino acids and is found in cells of various human organs.
The norm of AST in the blood of women is up to 31 U / ml.
An increase in the level of this enzyme most often indicates problems with the heart (in particular, with the myocardium), as well as liver diseases.
There are hepatic causes of increased ALT and AST - liver ischemia, viral hepatitis, hepatosis of the liver, and non-hepatic causes - hemolytic anemia (hemolysis), obesity, etc.
A slight increase in ALT and AST enzymes in the first and second trimester of pregnancy is not a consequence of the disease.
Creatinine is a metabolic product of creatine phosphate, which is involved in the process of providing human muscles with energy.
Creatinine is filtered in the kidneys, and in the event of a violation of their work, an increase in createnin in the human blood is observed.
Normative concentration of creatinine in the blood of a woman, mmol / l.
During pregnancy (usually in the 1st and 2nd trimesters), there is a decrease in this indicator by 40% due to an increase in blood volume, enhanced by the work of the kidneys, i.e. the content of creatinine during pregnancy decreases dokmol / l, which is a physiologically normal phenomenon.
If a pregnant woman is too thin or if a vegetarian diet is followed, this indicator can also be reduced, which in this case is not a good sign, it is necessary to gain weight by adjusting and balancing nutrition.
Urea is a nitrogen-containing product, which, along with creatinine, makes it clear how the excretory system of the kidneys works.
Cholesterol (or cholesterol) is an important building component of the cells of our body, most of which is produced in the liver, the rest - a person receives with food. Cholesterol is also involved in the production of sex hormones, so monitoring cholesterol levels and keeping it normal is an important task during the period of bearing a child.
Cholesterol norms according to the woman's age, mmol / l: With normal general blood counts, a two-fold increase in cholesterol during pregnancy is the norm, that is, each indicator in this table must be multiplied by 2. This increase is due to the active release of certain hormones into the woman's blood necessary for the formation of the placenta .
An increase in the cholesterol value (namely, on average, with indications of more than mmol / l) is observed in liver diseases, cholestasis, pancreatitis, renal failure, coronary heart disease, diabetes mellitus, obesity, etc.
Both for the baby and for the mother, elevated cholesterol is an extremely undesirable phenomenon, therefore, it is necessary to take measures to reduce it: change the diet to a lower calorie one, do exercises for pregnant women, etc.
Indeed, with an excess of cholesterol, the risk of intrauterine anomalies in the development of the cardiovascular system in the fetus increases, and the mother herself may suffer from a decrease in the strength of blood vessels, their blockage and the formation of blood clots, with a deficiency, the risk of spontaneous miscarriage or premature birth increases, and in a pregnant woman with reduced cholesterol, deterioration in well-being.
Glucose is the main blood marker for determining diabetes in humans. The norm of blood glucose is 3.89-5.83 mmol / l, but during pregnancy in healthy women this indicator is often reduced, because the fetus grows and needs more glucose, which it consumes from the mother's body.
Also, during the period of bearing a child, pregnant women experience gestational diabetes mellitus, which disappears after childbirth. These phenomena are considered within the normal range, since they are caused by the active release of glucose by the mother's body and its consumption by the developing fetus.
An increase in blood glucose indicates diabetes mellitus, kidney and liver diseases, pancreatitis.
A decrease in glucose can also be with endocrine pathologies, for example, with adrenal insufficiency.
Diastase (or alpha-amylase) is an enzyme that is synthesized in the pancreas and salivary glands, is present in small amounts in the liver and intestines, so this blood marker is used primarily to diagnose pancreatic diseases and inflammatory processes in the salivary glands, well and of course to confirm diseases of the liver and gastrointestinal tract.
The norm for an adult U / l.
An increase in the level of diastasis in the blood is observed with pancreatitis, cholecystitis, renal failure, diabetes mellitus, etc.
A decrease in the level of diastasis - with toxicosis, hepatitis, pancreatic insufficiency.
Gamma-glutamyl transferase or gamma-glutamyl transpeptidase (GGT (GGTP) or GGTP) is an enzyme that accumulates in the kidney, liver, and pancreas.
The norm of GGT for women is up to 36 U / ml.
During the second trimester of pregnancy, GGT may be slightly increased, which is within the normal range.
In diseases of the liver and biliary system (cholestasis, for example), there is a significant increase in the enzyme in the blood serum. GGT can also increase in diabetes mellitus.
Alkaline phosphatase (AP) is an enzyme primarily involved in bone growth.
The norm of alkaline phosphatase in women U / ml. An increase in this enzyme during fracture healing is considered normal.
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 the fetal bone tissue.
Also, an increase in alkaline phosphatase may indicate the presence of a disease of the bones or liver (for example, with hepatic cholestasis, hepatitis).
Also, with infectious mononucleosis, an increase in alkaline phosphatase is observed in the first week of the disease.
Taking antibiotics, magnesia, large doses of vitamin C, insufficient intake of foods 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 substances that play an important role in the functioning of the whole organism. Each of them is responsible for certain important processes: for muscle contractions, conduction of nerve impulses, metabolism in the human body, for maintaining somatic pressure, maintaining acid-base balance, functioning of the nervous system, oxygen transfer, etc.
Both an increase and a decrease in the content of macro- and microelements in the body of a pregnant woman leads to health problems for both the mother and the unborn child, so it is important to maintain these indicators in the normal range by taking specially designed vitamin and mineral complexes for pregnant women.
A biochemical blood test should be taken only in the morning and on an empty stomach, and the last meal should be 8-12 hours before the test.
Alcoholic liver disease (ALD) is one of the most common causes of chronic liver disease in the United States.
It develops in patients who consume more than a gram of alcohol per day (5 standard drinks per day), and in women 2 standard drinks per day. The diagnosis of ALD is confirmed by an increase in the content of transferases with an AST:ALT ratio of at least 2:1. Transferase levels are a useful test for detecting alcohol abuse. An increase in AST is a more specific test for detecting alcohol abuse.
In this case, the identification of GGTP is also useful. An increase in the GGTP content by more than 2 times with an AST:ALT ratio of at least 2:1 is a serious argument in favor of alcoholic liver disease.
The role of medicines, herbs and other substances
A meticulous history taking and analysis of laboratory data is important for the diagnosis of drug-induced aminotransferase elevations. Drug-induced and chemically-induced liver damage account for 1-2% of cases of chronic hepatitis. Chronic liver damage is associated with antibiotics, antiepileptic drugs, hydroxymethylglutaryl-CoA reductase inhibitors, NSAIDs, and anti-tuberculosis drugs.
The easiest way to link an increase in aminotransferase with any drug is to stop it and observe how this will affect its level. Without discontinuation of the drug, this relationship cannot be established.
High risk of chronic hepatitis C (HCV) in patients with parenteral injections, drug addicts, tattooed persons, sexual minorities. The most effective diagnostic method is the determination of antibodies to the HCV virus (sensitivity over 90%), which is usually confirmed by PCR.
In most patients with HCV infection, the increase in ALT is 1.5–2 times higher than that of AST. With the development of cirrhosis in patients with viral hepatitis, the ALT / AST ratio normalizes or AST is slightly increased.
An HBV DNA titer greater than 105 copies/mL and elevated ALT levels are indications for liver biopsy and antiviral therapy.
Autoimmune hepatitis (AIH) is more common in young middle-aged women. The ratio of males to females is 4:1. Serum protein determination is a useful screening test.
More than 80% of patients with AIH have hypergammaglobulinemia. Exceeding the normative indicators by more than 2 times is very important for establishing a diagnosis. Additional serological tests include antinuclear antibodies, antismooth muscle antibodies, antismooth muscle antibodies, and hepatic-renal microsomal antibodies, but these are sometimes negative. A biopsy is required for a definitive diagnosis.
Non-alcoholic fatty liver disease (NAFLD) The prevalence of NAFLD in the US population is 20% (.), and the estimated prevalence of NASH is 3%. In contrast to patients with alcoholic fatty liver disease, the ratio of AST/ALT in patients with NASH is less than 1:1.
It is traditionally believed that NASH affects obese, diabetic, middle-aged women more often. It is now established that NASH can also affect non-obese people without diabetes.
Fatty liver lesions may be associated with medications such as prednisolone, methotrexate, synthetic estrogens, amiodarone, tamoxifen, nifedipine, and dithiazem. NASH may result from massive exposure to organic solvents, prolonged parenteral nutrition, and some rare hereditary diseases.
In a number of patients, NASH can evolve into cirrhosis, and therefore how aggressive diagnostic methods we should use is an ambiguous question.
Ultrasound or CT often helps identify "fatty liver", but there are currently no effective treatments for it. Vitamin E, ursodiol, and drugs used to treat type 2 diabetes are being intensively researched in this regard.
Currently, the basic treatment consists of normalizing weight, controlling diabetes and treating hyperlipidemia.
Other Less Common Causes of Elevated Aminotransferases
Given the presence of other reasons for the increase in aminotransferases, the patient should be examined to rule out the following diseases. These diseases are relatively rare. A biopsy is often required to confirm the diagnosis.
Hemochromatosis (HC). This disease occurs in 1 in 300 people in the general population. With HC, serum ferritin is elevated and the percentage of iron saturation is increased and is confirmed by the presence of 2 copies of the HFE gene.
Characteristic manifestations: the patient has lethargy, arthralgia, decreased libido, but there are often asymptomatic cases. As a result, the start of treatment is delayed. HC should be considered if there is a slight increase in liver enzymes.
Wilson's disease (WV). Genetically determined disorder of biliary copper excretion. BV can be manifested solely by an increase in the level of liver enzymes. The disease manifests itself between the ages of 5 and 25, but is diagnosed more often by the age of 40. Occurs in approximately 1 person. A specific symptom of the Kaiser Fleischer ring, low levels of ceruloplasmin, increased excretion of copper in the urine, high concentrations of copper in the liver. Deficiency? 1 - antitrypsin. Not a rare hereditary disease of young white people that affects the liver. The decrease in ?1-antitrypsin is up to 20% of the norm and the decrease in ?1-globulin during electrophoresis. The diagnosis is confirmed by determining the phenotype of the protease inhibitor, since in inflammatory diseases there is an increase in α1-antitrypsin, which can give false negative results.
Low-symptom celiac disease (sprue). Celiac sprue is a common cause of abnormal liver tests. It is diagnosed on the basis of the determination of antigliadin and tissue transglutaminase antibodies. These indicators should be determined especially in cases where there is weight loss, abdominal tension, flatulence and steatorrhea (although these symptoms may not be present). According to the latest data, celiac sprue was the cause of a persistent increase in the content of aminotransferases in 14 out of 140 patients referred to the hepatology clinic.
Elevated ALT can be observed in patients with obstructive hepatobiliary disease, infiltrative liver disease, including primary and metastatic tumors, drug-induced liver disease, primary biliary cirrhosis.
A slight increase in ALT is observed in the first trimester of pregnancy and physiological bone growth and is not common in elderly patients over 50 years of age. Diagnosis is assisted by the determination of serum 5'nucleotidase or GGTP levels, which increase simultaneously with ALT in liver diseases.
An increase in conjugated bilirubin can occur with viral, chemical, or alcohol-induced lesions, as well as biliary obstruction and cirrhosis.
Gilbert's syndrome, the most common cause of elevated unconjugated bilirubin on normal liver tests, occurs in 5% of the population. Hemolysis can be differentiated from Gilbert's disease by reticulocyte count, red blood cell count, and blood microscopy. Hemolysis is characterized by reticulocytosis and abnormal microscopy, while these are normal in Gilbert's disease.
When to use imaging techniques and biopsy? Reserve imaging tests for those cases where ALT and/or AST are elevated and all other tests are normal.
Imaging is especially useful when ALT or GGTP are elevated. Investigations should be aimed at identifying biliary obstruction, intrahepatic (liver tumor) or extrahepatic (tumors or stones obstructing the bile ducts).
Liver biopsy is indicated in patients who have more than 2 times normal AST or ALT and other liver or imaging tests are negative.
“If ALT and AST levels are less than 2 times the upper limit of normal and chronic liver disease is not identified, only observation is recommended”
This post is based on this 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.
ALT (alanine aminotransferase, Alat, alat, GPT) is an enzyme necessary for the proper functioning of the entire body. Due to the rapid conversion into glucose, which is necessary for strengthening the immune system, the proper functioning of the central nervous system and the production of lymphocytes, alanine aminotransferase is indispensable for the functioning of all organ systems.
The highest concentration of GPT is recorded in the tissues of the liver, heart, pancreas and skeletal muscles. An elevated level of alanine aminotransferase indicates cell destruction and various disorders in the functioning of internal organs.
AST (aspartate aminotransferase, AsAt, asat) is an enzyme that activates biochemical processes in the body and takes part in the metabolism of amino acids. The maximum concentration is in the blood serum, liver, muscle tissue, heart, spleen, kidneys and pancreas.
The increase in aminotransferases is associated with the accumulation of dead cells and signals the onset of tissue necrosis. It is necessary to pay attention to the ratio of enzymes: if the ALT indicator is significantly higher than AST, this indicates problems with the liver, and when AST > ALT, then the patient needs to be checked for heart disease.
A uniform increase in these two indicators means the presence of muscle injuries.
If an increase in ALT and AST was detected during pregnancy, then it is necessary to find out the cause of the jump in order to exclude pathologies of the internal organs.
The most common sources of changes in enzyme levels are:
- Cardiological diseases.
- Pancreatitis (inflammation of the pancreas).
- Severe injuries, extensive or deep burns.
- The pressure of the baby in the womb on the liver.
- Taking medication to keep the pregnancy going.
- Increasing hormone levels.
- Strong physical activity.
- Viral infections.
- Changes in the liver tissues caused by the development of hepatitis.
If the indicators of hepatic transaminases have increased greatly, the doctor will refer the woman for an examination that excludes cirrhosis of the liver, cholecystitis, autoimmune hepatitis.
Any of these diseases can harm the woman and the fetus. If the level of ALT and AST enzymes is elevated during pregnancy, this is a clear sign that the body is not coping well with the load.
In especially severe cases, if there is a threat to the life of the mother and child, doctors are forced to immediately induce childbirth. If the case is not critical, then hospital treatment is prescribed.
Symptoms
Signs of a violation of the norm are mostly non-specific and can be easily mistaken for toxicosis, but there are those that clearly indicate problems with the liver. Even before testing and identifying diseases, a woman should pay attention to the manifestation of the following symptoms:
- loss of appetite;
- nausea;
- dyspepsia;
- vomit;
- yellowness of the skin and sclera;
- flatulence;
- general weakness;
- impaired blood clotting.
In the presence of such signs, a pregnant woman is prescribed a biochemical blood test, it is done on an empty stomach, early in the morning. For women, the rate of these enzymes should not exceed 31 units / l. During the first and second trimester, a slight increase in plasma levels of ALT and AST is considered normal.
In pregnant women, ALT levels increase in the 1st and 2nd trimesters by 5-10%, after which transaminases should return to normal. Sometimes the growth of the ALT enzyme is also observed during the 3rd trimester - against the background of manifestations of preeclampsia (late toxicosis).
Diagnostics
Pregnancy can cause an exacerbation of chronic pathologies, which can affect the formation of the fetus. Therefore, during this period, it is important to monitor changes in the body and conduct liver tests, which include determining the level of:
- albumen;
- bilirubin;
- alkaline phosphatase (AP)
- gamma-glutamyltransferase (GGT);
- general protein analysis.
In order to detect pathological processes, a routine examination is carried out at 38 weeks.
Decryption
Despite the fact that in pregnant women the level of enzymes in the bloodstream is slightly increased, their significant jump may indicate the presence of pathologies. If the patient has suspicions of liver disease, then you should pay attention to such indicators of ALT growth:
- fatty degeneration - up to 3 times;
- alcoholic hepatitis - 6 times or more;
- cirrhosis of the liver - from 4 to 5 times;
- acute viral hepatitis - races from 50 to 100 times.
- Liver carcinoma affects the increase in ALT and AST by 5-10 times.
If a pregnant woman has a serious excess of the norm of enzymes and there are other complaints, she is prescribed an examination by a general practitioner, endocrinologist, gastroenterologist, infectious disease specialist, hematologist, oncologist, urologist and hepatologist.
Treatment
It is possible to reduce the level of ALT and AST in the blood by eliminating the cause of their increase. If the analyzes did not reveal any serious deviations in the functioning of the internal organs, then the following measures are applied:
- cancel medicines, dietary supplements that could affect the functioning of organs;
- replace meat and fish with vegetable products;
- ban fatty and fried foods;
- the appointment of enzyme preparations (Pancreatin, Mezim, Festal, etc.).
Treatment is prescribed not only to improve the health of the woman, but also to maintain the pregnancy until the end of the term. In case of serious liver diseases, experts try to continue gestation until the maximum safe period for delivery.
An increase in liver enzymes is treated with a special diet and requires systematic monitoring of the pregnant woman and child.
A limited amount enters the bloodstream. Therefore, when a biochemical analysis shows an increased content of ALT, this indicates the presence of a number of abnormalities in the body and the development of serious diseases. Often they are associated with the destruction of organs, which leads to a sharp release of the enzyme into the blood. As a result, the activity of alanine aminotransferase is also enhanced. Establishing the extent of necrosis or the degree of tissue damage based on this is difficult, since the enzyme is not characterized by organ specificity.
The highest activity of alanine aminotransferase was found in the blood serum of men. In women, processes involving the enzyme proceed more slowly. The highest concentration is noted in the kidneys and liver, followed by skeletal muscles, spleen, pancreas, erythrocytes, lungs, heart.
What is analysis used for?
The largest amount of transferase was found in the liver. This observation is used to detect diseases of this organ that do not have external symptoms. ALT, unlike many other components considered in the biochemical analysis of blood, has been studied most fully. Therefore, it can be used to identify even minor problems in the body. In some cases, the amount of ALT is compared with the amount of other elements in the blood. This allows you to draw conclusions about the presence of pathologies.
The amount of alanine aminotransferase in liver problems helps to identify them even before the appearance of the most characteristic symptom - jaundice. Therefore, the doctor prescribes an analysis for ALT most often in order to check for damage to this important organ as a result of taking medications or any other substances that are toxic to the body. Also, the study is carried out with suspicion of hepatitis. ALT analysis is mandatory in the presence of symptoms such as increased fatigue and weakness of the patient. He loses his appetite, often feels nausea, turning into vomiting. Yellow spots on the skin, pain and discomfort in the abdomen, yellowing of the whites of the eyes, light-colored stools and dark urine can all be signs of liver disease. In such cases, this analysis is required.
When it is carried out, either venous or capillary blood is used. In order to obtain reliable results, certain requirements must be met. First, do not eat 12 hours before the date and do not drink alcohol for a week. Even a small amount of food can make a big difference. Secondly, within half an hour before the analysis, stop smoking, do not worry, avoid moral and physical overstrain. Results are usually ready a day after delivery.
Alanine aminotransferase (ALT, or ALT) are marker enzymes for the liver.
Aspartate aminotransferase (AST, or AST) is a marker enzyme for the myocardium.
ALT (AlAT) in children
ALT in children varies with age:
In newborns up to 5 days: ALT should not exceed 49 U / l. (AST up to 149 U / l.)
From one to three years - 33 U / l, but gradually the normal amount of the enzyme in the blood decreases
ALT (AlAT) in adults
Norm for men
Norm for women
up to 45 U / l. (0.5 - 2 µmol)
up to 34 U / l. (0.5 - 1.5 µmol)
28 - 190 mmol / l (0.12-0.88)
28 - 125 mmol / l (0.18-0.78)
Enzyme levels
Enzyme levels
What diseases increase AST and ALT?
Light - 1.5-5 times;
Average - 6-10 times;
High - 10 times or more.
Myocardial infarction (greater than AST);
Acute viral hepatitis (more than ALT);
Toxic damage to the liver;
Malignant tumors and metastases in the liver;
Skeletal muscle breakdown (crash syndrome)
But the results of the analysis for ALT are often far from the established norms. This may be due not only to the presence of inflammatory processes in the body, but also to other factors. Elevated levels of alanine aminotransferase can be triggered by taking aspirin, warfarin, paracetamol and oral contraceptives in women. Therefore, the doctor should be aware of the use of such drugs before testing for ALT. Medicines based on valerian and echinacea have a similar effect. Unreliable test results may be caused by increased motor activity or intramuscular injections.
Found a mistake in the text? Select it and a few more words, press Ctrl + Enter
ALT elevated in the blood
Hepatitis provokes an increase in ALT in the blood at a time, muscular dystrophy and dermatomyasitis - by 8. Gangrene, acute pancreatitis is indicated by an excess of the upper limit of the indicator by 3-5 times.
What does an increase in ALT mean?
Hepatitis. This inflammatory liver disease can present in several forms. For chronic or viral hepatitis, the excess of the level of alanine aminotransferase in the blood is insignificant. In hepatitis A, ALT analysis makes it possible to detect the infection in advance. The amount of enzyme in the blood increases a week before the first external manifestations of the disease appear in the form of jaundice. Viral or alcoholic hepatitis is accompanied by a pronounced increase in ALT levels.
Liver cancer. This malignant tumor is often formed in patients with hepatitis. Analysis for ALT in this case is necessary both for diagnosing the disease and for making a decision on the surgical decision. When the level of alanine aminotransferase significantly exceeds the norm, surgical intervention may not be possible, since the risk of various complications is high.
Pancreatitis. The presence of this disease is also indicated by the level of ALT. Its increased amount indicates an exacerbation of pancreatitis. Patients with this diagnosis will have to be periodically tested for ALT throughout their lives. This will help to avoid attacks of the disease and monitor the progress of treatment.
Myocarditis. It manifests itself in lesions of the heart muscle. Its main symptoms are shortness of breath, rapid fatigue of the patient and an increased content of ALT in the blood. To diagnose this disease, the level of AST is determined, and then the de Ritis coefficient is calculated.
Cirrhosis. This disease is dangerous because for a long time it may not have pronounced symptoms. Patients quickly get tired, feel tired. Less often there are pains in the area of a liver. In this case, cirrhosis can be determined by the elevated content of ALT in the blood. The amount of enzyme in the blood can exceed the norm by 5 times.
Myocardial infarction. This disease is a consequence of impaired blood flow, resulting in necrosis of the tissues of the heart muscle. In the case of an uncomplicated myocardial infarction, the level of ALT rises slightly compared to AST, however, it can be used to determine an attack.
Reasons for the increase in ALT
steatosis - a disease that manifests itself in the accumulation of fat cells in the liver, most often occurs in overweight people;
necrosis of a malignant tumor;
taking drugs;
lead poisoning of the body;
mononucleosis - an infectious disease that manifests itself in a change in the composition of the blood, damage to the liver and spleen;
ALT elevated during pregnancy
In women, the amount of alanine aminotransferase is limited to 31 U / l. However, in the first trimester of pregnancy, a slight excess of this value is possible. This is not considered a deviation and does not indicate the development of any disease. In general, ALT and AST levels should be stable throughout pregnancy.
A slight increase in the number of enzymes of this group is observed with gestosis. In this case, they have a light or medium severity. Preeclampsia is a complication that occurs in late pregnancy. Women experience weakness, dizziness and nausea. Their blood pressure rises. The greater the deviation of ALT from the norm, the more severe the preeclampsia. This is the result of too much stress on the liver that it cannot handle.
How to lower ALT in the blood?
It is possible to reduce the content of alanine aminotransferase in the blood by eliminating the cause of this phenomenon. Since diseases of the liver and heart are the most common factor in increasing ALT, it is necessary to start with their treatment. After a course of procedures and taking the appropriate drugs, a biochemical blood test is repeated. With proper treatment, ALT levels should return to normal.
Sometimes special drugs are used to lower it, such as hefitol, heptral, duphalac. They should be prescribed by a doctor, and the reception is carried out under his supervision. Most drugs have contraindications that must be considered before starting treatment. However, such remedies do not eliminate the underlying cause of the increase in ALT. Some time after taking the drugs, the level of the enzyme may change again. Therefore, it is necessary to contact a qualified specialist who will make the correct diagnosis and prescribe the appropriate treatment.
3. Herpes simplex virus
5. on the thyroid gland: TSH, T3, T4
If all is well, then you can plan a pregnancy.
The information on the site is intended for familiarization and does not call for self-treatment, a doctor's consultation is required!
Alt during pregnancy is normal
Cancer treatment in Israel. Review of the patient Top Ichilov.
Alanine aminotransferase or ALT is an enzyme that is located 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.
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 it is completely normal.
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.
Aspartate aminotransferase or AST is present in the liver, myocardium, muscles, kidneys, pancreas, and red blood cells. AST is available in two forms - mitochondrial (70%) and cytoplasmic (30%). The release of cytoplasmic AST, which is less, occurs with moderate liver damage. And mitochondrial (which is 2.5 times more) is released with more severe destruction and the achievement of a pathological process to mitochondria.
A false increase in AST during pregnancy can occur as a result of hemolysis of red blood cells, 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 it should be completely normal. After childbirth, AST can grow due to active muscular labor activity.
Gamma-glutamyltransferase
Gamma-glutamyltransferase, or GGT, rises in cholestasis, an impaired flow of bile through the biliary tract. GGT decreases in the 1st and 3rd trimesters of pregnancy, and in the second it may increase slightly. In acute and exacerbation of chronic liver diseases, GGT increases.
Alkaline phosphatase
Alkaline phosphatase or alkaline phosphatase is elevated in diseases of the liver and bones. ALP in adults is more indicative of hepatic cholestasis in pregnant women. The values of alkaline phosphatase in the blood of pregnant women change with each trimester. In the first third, it may decrease, and in the second and third, it will grow. In the second - by a third of the norm, in the third - an increase of up to 2 times.
The rate of alkaline phosphatase in the blood is 0.7-2.1 ?kat/l. In the third trimester, it can normally reach 4.2 ?kat/l.
total bilirubin
Bilirubin is formed in the process of hemoglobin metabolism. Excreted by the liver. In the blood of pregnant women, bilirubin in the first or second trimester may decrease by %, and in the third - by 10-30%. If a pregnant woman has an elevated level of bilirubin in the results of liver tests, you should immediately consult a doctor to determine the cause. The most likely exacerbation of chronic liver disease or infection with viral hepatitis.
The norm of total bilirubin in the blood is 3.4 - 17.1 mol / l.
Maybe someone had such a situation or someone knows something about it, something I can’t fully trust my doctor.
All tests are normal, except for ALT (increased to 66 at a rate of up to 40). Hepatitis is negative.
I studied the annotations for all the drugs that I drink. In the annotation to utrozhestan (still not canceled, 200 mg daily) it is written during pregnancy for a long time with extreme caution, because. may cause liver dysfunction. I drew the attention of the doctor today to this, and she says to me, “Because of this, it cannot be.”
She prescribed an ultrasound scan of the abdominal organs (liver, kidneys, gallbladder) and Essentiale. Is it dangerous to do such an ultrasound during pregnancy?
Because of what there can be an increase only in this enzyme?
ALT in the blood
What does ALT in the blood show?
Alanine aminotransferase, or ALT for short, is a special endogenous enzyme. It is included in the transferase group and the aminotransferase subgroup. The synthesis of this enzyme takes place intracellularly. A limited amount enters the bloodstream. Therefore, when a biochemical analysis shows an increased content of ALT, this indicates the presence of a number of abnormalities in the body and the development of serious diseases. Often they are associated with the destruction of organs, which leads to a sharp release of the enzyme into the blood. As a result, the activity of alanine aminotransferase is also enhanced. It is difficult to establish the extent of necrosis or the degree of tissue damage based on this, since the enzyme is not characterized by organ specificity.
Alanine aminotransferase is found in many human organs: kidneys, heart muscle, liver, and even skeletal muscles. The main function of an enzyme is to exchange amino acids. It acts as a catalyst for the reversible transfer of alanine from the amino acid to alpha-ketoglutarate. As a result of the transfer of the amino group, glutamic and pyruvic acids are obtained. Alanine in the tissues of the human body is necessary, as it is an amino acid that can quickly turn into glucose. Thus, it is possible to obtain energy for the functioning of the brain and central nervous system. In addition, among the important functions of alanine is the strengthening of the body's immune system, the production of lymphocytes, and the regulation of the metabolism of acids and sugars.
The highest activity of alanine aminotransferase was found in the blood serum of men. In women, processes involving the enzyme proceed more slowly. The highest concentration is noted in the kidneys and liver, followed by skeletal muscles, spleen, pancreas, erythrocytes, lungs, heart.
What is analysis used for?
The largest amount of transferase was found in the liver. This observation is used to detect diseases of this organ that do not have external symptoms. ALT, unlike many other components considered in the biochemical analysis of blood, has been studied most fully. Therefore, it can be used to identify even minor problems in the body. In some cases, the amount of ALT is compared with the amount of other elements in the blood. This allows you to draw conclusions about the presence of pathologies.
For example, an enzyme such as aspartate aminotransferase or AST is often used. It is also synthesized intracellularly, and a limited amount enters the bloodstream. Deviation from the standard established in medicine for the content of aspartate aminotransferase, as in the case of alanine aminotransferase, is a manifestation of deviations in the work of some organs. The most complete picture of the nature of the pathology allows you to get the correlation of the contained amount of both enzymes. If there is an excess of alanine aminotransferase over aspartate aminotransferase, this indicates the destruction of liver cells. The level of AST rises sharply in the later stages of the disease of this organ, such as cirrhosis. When the level of aspartate aminotransferase exceeds the content of alanine aminotransferase, problems with the heart muscle are observed.
Additional diagnostic methods allow to confirm the presence of the disease and the degree of organ damage. However, ALT is an accurate indicator; in some cases, it can even be used to establish the stage of the disease and suggest possible options for its development.
When is an ALT test ordered?
The amount of alanine aminotransferase in liver problems helps to identify them even before the appearance of the most characteristic symptom - jaundice. Therefore, the doctor prescribes an analysis for ALT most often in order to check for damage to this important organ as a result of taking medications or any other substances that are toxic to the body. Also, the study is carried out with suspicion of hepatitis. ALT analysis is mandatory in the presence of symptoms such as increased fatigue and weakness of the patient. He loses his appetite, often feels nausea, turning into vomiting. Yellow spots on the skin, pain and discomfort in the abdomen, yellowing of the whites of the eyes, light-colored stools and dark urine can all be signs of liver disease. In such cases, this analysis is required.
ALT can be compared with AST for more information on the causes of liver damage. This is done if the number of enzymes significantly exceeds the norm. The ratio of AST to ALT is known in medicine as the de Ritis ratio. Its normal value ranges from 0.91 to 1.75. If this indicator becomes more than 2, then damage to the heart muscle is diagnosed, which occurs with the destruction of cardiomyocytes. Myocardial infarction is also possible. The de Ritis coefficient, not exceeding 1, indicates liver disease. Moreover, the lower the value of the indicator, the greater the risk of an adverse outcome.
ALT analysis can be used not only as a diagnostic method, but also during treatment. This allows you to determine the dynamics of the course of the disease and identify improvements or deterioration in the patient's condition. An ALT test is necessary if factors contributing to liver disease are present. These include the abuse of alcoholic beverages or drugs that destroy the cells of the body. If the normal amount of alanine aminotransferase in the blood is exceeded, other drugs are prescribed. It is imperative to check the amount of ALT if the patient has been in contact with patients with hepatitis or has recently had it himself, has diabetes and is overweight. Some people are predisposed to liver disease. They are also shown an analysis for ALT.
When it is carried out, either venous or capillary blood is used. In order to obtain reliable results, certain requirements must be met. First, do not eat 12 hours before the date and do not drink alcohol for a week. Even a small amount of food can make a big difference. Secondly, within half an hour before the analysis, stop smoking, do not worry, avoid moral and physical overstrain. Results are usually ready a day after delivery.
The norm of ALT in the blood in men and women
The amount of the enzyme alanine aminotransferase in the blood is measured in units per liter.
Depending on the gender and age of the patient, its value ranges from 0 to 50:
In newborns up to 5 days of age, ALT should not exceed 49 U / l.
For children up to six months, this figure is higher - 56 U / l.
At the age of six months to a year, the amount of ALT in the blood can reach 54 U / l
From one to three - 33, but gradually the normal amount of the enzyme in the blood decreases
In children from 3 to 6 years old, its upper limit is 29 U / l.
In children, minor deviations from the norm are allowed. This is due to uneven growth. Over time, the amount of enzyme in the blood should stabilize and approach normal.
the upper limit of the indicator is 40 U / l.
But the results of the analysis for ALT are often far from the established norms. This may be due not only to the presence of inflammatory processes in the body, but also to other factors. Elevated levels of alanine aminotransferase can be triggered by taking aspirin, warfarin, paracetamol and oral contraceptives in women. Therefore, the doctor should be aware of the use of such drugs before testing for ALT. Medicines based on valerian and echination have a similar effect. Unreliable test results may be caused by increased motor activity or intramuscular injections.
Found a mistake in the text? Select it (a few words!) and press Ctrl + Enter - Inaccurate recipe? - write about it to us, we will definitely clarify it from the source! - Something else? - write to us, we will clarify the information!
ALT elevated in the blood
The amount of alanine aminotransferase in the blood is considered elevated if it exceeds the established norm, especially by tens, and in some cases hundreds of times. Depending on this, the presence of the disease is determined. With an increase in the level of ALT by 5 times, myocardial infarction can be diagnosed, if it reaches times, we can talk about the deterioration of the patient's condition after an attack. The value of the de Ritis coefficient in this case also changes upwards.
Hepatitis provokes an increase in the content of the enzyme in the blood at a time, muscular dystrophy and dermatomyasitis - by 8. Gangrene, acute pancreatitis are indicated by an excess of the upper limit of the indicator by 3-5 times.
It is possible not only to increase the content of alanine aminotransferase in the blood. Its too low amount is associated with a lack of the B6 organism, which is part of this enzyme, or with complex inflammatory processes in the liver.
What does an increase in ALT mean?
An increase in ALT indicates the course of inflammatory processes in the body. They can be caused by the following diseases:
This inflammatory liver disease can present in several forms. For chronic or viral hepatitis, the excess of the level of alanine aminotransferase in the blood is insignificant. In hepatitis A, ALT analysis makes it possible to detect the infection in advance. The amount of enzyme in the blood increases a week before the first external manifestations of the disease appear in the form of jaundice. Viral or alcoholic hepatitis is accompanied by a pronounced increase in ALT levels.
This malignant tumor is often formed in patients with hepatitis. Analysis for ALT in this case is necessary both for diagnosing the disease and for making a decision on the surgical decision. When the level of alanine aminotransferase significantly exceeds the norm, surgical intervention may not be possible, since the risk of various complications is high.
The presence of this disease is also indicated by the level of ALT. Its increased amount indicates an exacerbation of pancreatitis. Patients with this diagnosis will have to be periodically tested for ALT throughout their lives. This will help to avoid attacks of the disease and monitor the progress of treatment.
It manifests itself in lesions of the heart muscle. Its main symptoms are shortness of breath, rapid fatigue of the patient and an increased content of ALT in the blood. To diagnose this disease, the level of AST is determined, and then the de Ritis coefficient is calculated.
This disease is dangerous because for a long time it may not have pronounced symptoms. Patients quickly get tired, feel tired. Less often there are pains in the area of a liver. In this case, cirrhosis can be determined by the elevated content of ALT in the blood. The amount of enzyme in the blood can exceed the norm by 5 times.
This disease is a consequence of impaired blood flow, resulting in necrosis of the tissues of the heart muscle. In the case of an uncomplicated myocardial infarction, the level of ALT rises slightly compared to AST, however, it can be used to determine an attack.
Reasons for the increase in ALT
Taking a number of medicinal or herbal preparations - barbiturates, statins, antibiotics;
frequent use of fast food before taking an analysis for ALT;
drinking alcohol less than a week before blood sampling;
non-compliance with the basic rules for the delivery of analysis, including the sterility of the procedure;
increased emotional or physical stress;
carrying out shortly before the analysis of catheterization of the heart muscle or other surgical intervention;
steatosis - a disease that manifests itself in the accumulation of fat cells in the liver, most often occurs in overweight people;
Norms of indicators of a biochemical blood test during pregnancy
Bilirubin is a blood pigment formed as a result of the breakdown of hemoglobin, the change in the concentration of which is directly related to the state of the liver and spleen.
There are two types of bilirubin (fractions): direct (or bound) and indirect (free or not bound), and their sum gives a quantitative estimate of total bilirubin in human blood. The norm of indirect bilirubin is 3.4-13.7 μmol / l, and direct - 0-7.9 μmol / l. Then the normative content of total bilirubin in the blood is in the range of 3.4-21.6 µmol/l.
As a rule, total and direct bilirubin are displayed in the results of a biochemical blood test, and their difference, respectively, will be the amount of indirect bilirubin in human blood.
For diagnostic purposes, the level of bilirubin is useful in determining jaundice, liver disease, cholestasis, hemolytic anemia, infectious mononucleosis. In these diseases, there is an increase in both direct and indirect bilirubin.
During pregnancy, there is often an increase in indirect bilirubin with normal readings of hemoglobin, ALT, AST, GGT and direct bilirubin, as well as good ultrasound of the liver and gallbladder. There is nothing to worry about, this phenomenon is called Gilbert's syndrome - this is a congenital disease that persists throughout life and does not pose a risk to the development of the child.
It is recommended to take Essentiale forte 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, drinking a few sips of water) for for 10 days to help your liver cope with the load, as well as adhere to proper nutrition, you can’t starve!
Alanine transaminase or alanine aminotransferase (ALT or ALT) is an intracellular enzyme that is found to a greater extent in the liver and kidneys, and to a lesser extent in the heart muscle, lungs, pancreas and spleen.
The norm of the ALT enzyme in the blood of a woman is up to 31 U / ml.
When the cells of these organs are destroyed, a significant release of ALT into the blood is observed, which happens with hepatitis, fatty liver hepatosis, jaundice, toxic liver damage, pancreatitis, heart disease and other serious diseases.
With late toxicosis (gestosis) during pregnancy, there may be a slight increase in ALT.
Aspartate aminotransferase (AST) is an enzyme that, like ALT, is involved in the metabolism of amino acids and is found in cells of various human organs.
The norm of AST in the blood of women is up to 31 U / ml.
An increase in the level of this enzyme most often indicates problems with the heart (in particular, with the myocardium), as well as liver diseases.
There are hepatic causes of increased ALT and AST - liver ischemia, viral hepatitis, hepatosis of the liver, and non-hepatic causes - hemolytic anemia (hemolysis), obesity, etc.
A slight increase in ALT and AST enzymes in the first and second trimester of pregnancy is not a consequence of the disease.
Creatinine is a metabolic product of creatine phosphate, which is involved in the process of providing human muscles with energy.
Creatinine is filtered in the kidneys, and in the event of a violation of their work, an increase in createnin in the human blood is observed.
Normative concentration of creatinine in the blood of a woman, mmol / l.
During pregnancy (usually in the 1st and 2nd trimesters), there is a decrease in this indicator by 40% due to an increase in blood volume, enhanced by the work of the kidneys, i.e. the content of creatinine during pregnancy decreases dokmol / l, which is a physiologically normal phenomenon.
If a pregnant woman is too thin or if a vegetarian diet is followed, this indicator can also be reduced, which in this case is not a good sign, it is necessary to gain weight by adjusting and balancing nutrition.
Urea is a nitrogen-containing product, which, along with creatinine, makes it clear how the excretory system of the kidneys works.
Cholesterol (or cholesterol) is an important building component of the cells of our body, most of which is produced in the liver, the rest - a person receives with food. Cholesterol is also involved in the production of sex hormones, so monitoring cholesterol levels and keeping it normal is an important task during the period of bearing a child.
Cholesterol norms according to the woman's age, mmol / l: With normal general blood counts, a two-fold increase in cholesterol during pregnancy is the norm, that is, each indicator in this table must be multiplied by 2. This increase is due to the active release of certain hormones into the woman's blood necessary for the formation of the placenta .
An increase in the cholesterol value (namely, on average, with indications of more than mmol / l) is observed in liver diseases, cholestasis, pancreatitis, renal failure, coronary heart disease, diabetes mellitus, obesity, etc.
Both for the baby and for the mother, elevated cholesterol is an extremely undesirable phenomenon, therefore, it is necessary to take measures to reduce it: change the diet to a lower calorie one, do exercises for pregnant women, etc.
Indeed, with an excess of cholesterol, the risk of intrauterine anomalies in the development of the cardiovascular system in the fetus increases, and the mother herself may suffer from a decrease in the strength of blood vessels, their blockage and the formation of blood clots, with a deficiency, the risk of spontaneous miscarriage or premature birth increases, and in a pregnant woman with reduced cholesterol, deterioration in well-being.
Glucose is the main blood marker for determining diabetes in humans. The norm of blood glucose is 3.89-5.83 mmol / l, but during pregnancy in healthy women this indicator is often reduced, because the fetus grows and needs more glucose, which it consumes from the mother's body.
Also, during the period of bearing a child, pregnant women experience gestational diabetes mellitus, which disappears after childbirth. These phenomena are considered within the normal range, since they are caused by the active release of glucose by the mother's body and its consumption by the developing fetus.
An increase in blood glucose indicates diabetes mellitus, kidney and liver diseases, pancreatitis.
A decrease in glucose can also be with endocrine pathologies, for example, with adrenal insufficiency.
Diastase (or alpha-amylase) is an enzyme that is synthesized in the pancreas and salivary glands, is present in small amounts in the liver and intestines, so this blood marker is used primarily to diagnose pancreatic diseases and inflammatory processes in the salivary glands, well and of course to confirm diseases of the liver and gastrointestinal tract.
The norm for an adult U / l.
An increase in the level of diastasis in the blood is observed with pancreatitis, cholecystitis, renal failure, diabetes mellitus, etc.
A decrease in the level of diastasis - with toxicosis, hepatitis, pancreatic insufficiency.
Gamma-glutamyl transferase or gamma-glutamyl transpeptidase (GGT (GGTP) or GGTP) is an enzyme that accumulates in the kidney, liver, and pancreas.
The norm of GGT for women is up to 36 U / ml.
During the second trimester of pregnancy, GGT may be slightly increased, which is within the normal range.
In diseases of the liver and biliary system (cholestasis, for example), there is a significant increase in the enzyme in the blood serum. GGT can also increase in diabetes mellitus.
Alkaline phosphatase (AP) is an enzyme primarily involved in bone growth.
The norm of alkaline phosphatase in women U / ml. An increase in this enzyme during fracture healing is considered normal.
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 the fetal bone tissue.
Also, an increase in alkaline phosphatase may indicate the presence of a disease of the bones or liver (for example, with hepatic cholestasis, hepatitis).
Also, with infectious mononucleosis, an increase in alkaline phosphatase is observed in the first week of the disease.
Taking antibiotics, magnesia, large doses of vitamin C, insufficient intake of foods 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 substances that play an important role in the functioning of the whole organism. Each of them is responsible for certain important processes: for muscle contractions, conduction of nerve impulses, metabolism in the human body, for maintaining somatic pressure, maintaining acid-base balance, functioning of the nervous system, oxygen transfer, etc.
Both an increase and a decrease in the content of macro- and microelements in the body of a pregnant woman leads to health problems for both the mother and the unborn child, so it is important to maintain these indicators in the normal range by taking specially designed vitamin and mineral complexes for pregnant women.
A biochemical blood test should be taken only in the morning and on an empty stomach, and the last meal should be 8-12 hours before the test.
- Rib pain during pregnancy
- Planned ultrasound during pregnancy at how many weeks
- 4D ultrasound during pregnancy photo
- Viburkol during pregnancy reviews
- Aqualor during pregnancy reviews
- Azithromycin during pregnancy reviews
- The second screening during pregnancy is normal
- Activated charcoal during pregnancy reviews
- Amoxiclav during pregnancy
- Headache during pregnancy 2nd trimester
Navigation
Information
I am pregnant - all about pregnancy, childbirth and children (0.019 sec.)