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Pregnancy does not change liver size. In the third trimester, the enlarging uterus displaces the uk liver superiorly and posteriorly. Therefore, a palpable liver suggests significant hepatomegaly and underlying liver disease. A small amount of peripheral edema is also uk common during pregnancy, as are some findings that usually connote chronic liver disease, such as spider angiomas and palmar erythema. These findings are signs of high circulating estrogen levels. Pregnancy does not alter the expected values for serum uk bilirubin, aminotransferases, g-glutamyl transpeptidase or 5'-nucleotidase, or the INR/prothrombin time. Dilution from the expanded plasma volume causes a 10 g/L fall in serum albumin and in total protein. Alkaline phosphatase, primarily of placental and skeletal origin, increases 1.5 times normal after the fifth week. Alkaline phosphatase may remain elevated for up to six weeks after delivery. There is an increase in serum globulin, total cholesterol and triglyceride.
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