High ALT/AST & Low Platelets in Pregnancy: Risks & Concerns

Question
i m female , got married 18 months ago and now i m in 3rd trimester of pragnenacy 20 days ago i felt pain in my upper abdomen as i went to dr she suggested me some tests. in reports my platelets were 118,000 and my ALT & AST were 140 and 160 respectively. the doctor asked me for tests again  after few days and this time when there are only 25 days left in my delivery date my platelets are 90,000 and my ALT & AST are 210 and 291 respectively. is it dangerous for me and my baby. i m much worried as its our 1st baby we are very excited. even my hepatits tests  ( A, B , C, E)are negative ,

Answer
There are a few things that can cause elevated ALT and AST with a lowered platelet count. One of which would have been hepatitis, since this has been ruled out then you may want to ask about being tested for Pre-Ecclampsia or HELLP Syndrome. These are two conditions that affect the liver and would alter the normal lab values when liver enzymes are checked. These are both very serious conditions. Given the upper abdominal pain, I would be more suspecting of HELLP Syndrome. The phrase "HELLP" comes from H - hemolysis E&L - elevated liver enzymes L&P - low platelets. This is a very concerning condition and will require close care by your OB/GYN and ultimately, an early delivery of the baby. Some of the symptoms include: Fatigue, Fluid retention, Headache, Nausea and vomiting (that is persistent), Pain in the upper right quadrent of the abdomen, Blurry vision, Enlarged Liver, Swelling in the legs or lower extremeties and abdominal tenderness. This condition is typically treated by delivering the baby. This condition can be life threatening and should be ruled out right away. Where I am located, it is considered a medical emergency should symptoms of this arise and people with those symptoms are advised to be seen immediately and without delay. With anything like Pre-Ecclampsia, or HELLP, you have a risk of damaging your liver permanently, this is why doctors choose to deliver the baby immediately upon finding these values and symptoms. With less than a month remaining in your pregnancy, your baby would be just fine if delivered. Where are you located? You should really consult your OB/GYN and ask him about these conditions. This is a fairly significant finding and should be treated fairly quickly. Please do follow up with me to let me know how you make out. I wish you the best of luck and would love to follow up with you once you have spoken to your OB/GYN. Please do not hesitate to contact me further if you have any more questions or concerns.

Sincerely,
Cheryl Hetherington