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Practice Guideline
. 2025 Jul;170(1):28-48.
doi: 10.1002/ijgo.70161. Epub 2025 Apr 29.

FIGO guideline on liver disease and pregnancy

Melanie Nana  1 , Virna Medina  2 , Cynthia Maxwell  3 , Ciara McCormick  4 , Gloria Taliani  5 , Ulrich Beuers  6 , Deborah Money  7 , Bo Jacobsson  8 , Anil Kapur  9 , Titus Beyuo  10 , Francisco Ruiloba  11 , Graeme Smith  12 , Lina Bergman  13 , Sharleen O'Reilly  4 , Patrick O'Brien  14 , Mark Hanson  15 , Mary Rosser  16 , Claudio Sosa  17 , Sumaiya Adam  18 , Valerie Guinto  19 , Liona Poon  20 , Fionnuala McAuliffe  4 , Catherine Williamson  21 ; FIGO Committee on Impact of Pregnancy on Long‐term Health, FIGO Committee on Infections during Pregnancy and the FIGO Division of Maternal and Newborn Health
Affiliations
Practice Guideline

FIGO guideline on liver disease and pregnancy

Melanie Nana et al. Int J Gynaecol Obstet. 2025 Jul.

Abstract

The number of women entering pregnancy with chronic liver disease is rising. Gestational liver disorders affect 3% of the pregnant population. Both can be associated with significant maternal and fetal morbidity and mortality. European guidance has recently been published to inform management. This FIGO (the International Federation of Gynecology & Obstetrics) guideline aims to use the latest evidence to inform practice relevant to a global population. The immediate past and present chairs of FIGO's Committee on the Impact of Pregnancy on Long-term Health invited the Chair of the European guideline, alongside two trainees with an interest in liver disorders in pregnancy, to develop a guideline relevant to a global audience, thus serving the real-world population and fulfilling FIGO's ambition to enhance their global voice for women's health. Experts in the field with experience in managing liver disorders in pregnancy from a diverse selection of continents helped to develop a guideline. The guideline includes the most common pre-existing and gestational liver disorders. Evidence-based best practice recommendations are summarized in addition to pragmatic recommendations. Printable tables/figures are included in the guideline for ease of use. These include a table of normal ranges of commonly used blood tests, a table outlining safety of investigations, and a table of delivery considerations relevant to a global audience. Figures designed to summarize each section of the guideline and the multidisciplinary approach to managing liver disorders in pregnancy are also included. This guideline incorporates guidance for a global audience aimed at improving the management of women with pre-existing and new liver disease in pregnancy.

Keywords: guideline; liver disease; pregnancy.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Recommended multidisciplinary team.
FIGURE 2
FIGURE 2
Summary of management of intrahepatic cholestasis of pregnancy.
FIGURE 3
FIGURE 3
Summary of acute fatty liver of pregnancy.
FIGURE 4
FIGURE 4
Summary of viral disorders.
FIGURE 5
FIGURE 5
Summary of cirrhosis in pregnancy.
See this image and copyright information in PMC

References

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