30th June 2023

Gastroenterology

Progesterone has several effects on gut motility, including reduced peristalsis and delayed gastric emptying. It also, unfortunately, reduces the pressure of the oesophageal sphincter. This results in reflux and constipation, which can be difficult to manage.

Liver metabolism is increased in pregnancy, further impacting on drug levels. The haemodilution seen decreases the total protein concentration due to the fall in albumin. ALT and AST fall slightly in normal pregnancy and bilirubin should remain unchanged.

Alkaline phosphatase is produced by the placenta and, therefore, will show an elevated blood level; the machine doesn’t routinely separate liver, bone, and placenta alkaline phosphatase.