![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2F4b117ec5-4ace-4d0a-b271-a481a549e5bb%2FUntitled.png?table=block&id=b6d3eb7f-edaf-498a-8b3d-81b81abcaa10&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Fb6c656b7-36a6-4dfb-8b69-e5057f8e4705%2FUntitled.png?table=block&id=31fd15fb-5a3c-4401-8168-5d0668996c8c&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2F815bf14d-606e-4901-ad4e-019241de6fef%2FUntitled.png?table=block&id=c1b9a7af-6dcc-472c-85cf-e2a1dee82715&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Fbe0406e6-c29c-4798-bcb0-7076bb54c3b2%2FUntitled.png?table=block&id=9e035631-bd59-45cc-8b60-7bfcd6691404&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Ff8c991c3-ecc6-4e17-812b-dbc89bb98bcf%2FUntitled.png?table=block&id=97fa3304-2f3b-49b4-8fea-b10021740d06&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Fea36fba5-bb92-44f5-b90b-690d483429b9%2FUntitled.png?table=block&id=e7352b66-d2df-40b1-a969-6c1fea01d5de&cache=v2)
prenancy can sometimes mimick liver failure because both are hyperestrogenemic state. one for incressed prodction and one descresed metabolism.
nausea and vomitting in third trimester is abnormal
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Fa92243a3-80be-4133-98e8-2440423240de%2FUntitled.png?table=block&id=7ecaeb60-9abf-4eef-8a72-a74e7f33df0c&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2F5bb5370e-d6b2-4730-9eb5-1c1c04a42340%2FUntitled.png?table=block&id=14fd39a1-12f5-4a5b-b8a9-0f5ab83097b2&cache=v2)
UA for preclamsia and thrombocytopeinia in severe preclamsia
total bile acids should be ordered seperately of liver fucntion and is diagnostic of cholestatisi
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2F9d4b19fe-a18c-443a-880f-dd0abbe48df2%2FUntitled.png?table=block&id=f6c70fbf-421d-49cc-a772-0c2abfd85ad3&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Fd6efa0b0-3560-4a06-a032-746068799ee7%2FUntitled.png?table=block&id=ef746112-9e80-4b9a-84e2-51c37024b99e&cache=v2)
MULTIPLE GESTATION - increased risk of almost everything but post term delivery
be carefl with fluid given becase can lead to oedema
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Fa2bbb288-d3db-4990-b47f-f95e2f5838ad%2FUntitled.png?table=block&id=2e1d73d5-4aa4-440f-9677-3ddbad5e3170&cache=v2)
Can also be hypermesisi gravidarum or HELLP as well as DD.
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Ff773b304-bb06-406b-9af0-777cb2e5db48%2FUntitled.png?table=block&id=2c4e9ee1-088e-46f3-aef2-9423e5586d37&cache=v2)
no biliary dilatation ⇒ case intrahepatic cholestasis
intra hepatic choletais can lead to feta demise
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2Fd9efb31d-457e-49af-a120-755f18fb9d41%2FUntitled.png?table=block&id=1f4b2f66-918c-4edc-8249-a76779a3606c&cache=v2)
HELLP syndrome a compication of severe pre eclamsia
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2F705bacdf-9ecc-45f4-8f74-3847febaf5e2%2FUntitled.png?table=block&id=9a16de0e-f664-41c2-b98b-a032251e2053&cache=v2)
![notion image](https://www.notion.so/image/https%3A%2F%2Fs3-us-west-2.amazonaws.com%2Fsecure.notion-static.com%2F5e22c2d4-a027-4450-8991-f0ea9223743d%2FUntitled.png?table=block&id=6d641a9a-513c-49d4-9f12-ae15ba14388c&cache=v2)