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In pregnant women, alkaline phosphatase high in the third trimester are usually on the higher side and is a normal sign. The reason behind this is the production of ALP by the placenta. The cell name syncytiotrophoblasts of the plasma membrane are responsible for the secretion of ALP.
Alkaline phosphatase may be derived from several sites including the liver, bone, third trimester placenta, intestine, and kidneys. An elevation in alkaline phosphatase with a normal gamma-glutamyl transpeptidase or 5'-nucleotidase suggests a nonhepatic source of alkaline phosphatase.
Liver abnormalities detected during pregnancy require diagnostic evaluation similar to the evaluation of the nonpregnant patient but is also informed by gestational age and expected physiologic changes of pregnancy.
High alkaline phosphatase levels in the liver may indicate the following conditions: Cholestasis of pregnancy: This is a common liver disease that can develop late in pregnancy. Cirrhosis of the liver: Cirrhosis is a late-stage liver disease in which healthy liver tissue is replaced with scar tissue and the liver is permanently damaged.
Does High Alkaline Phosphatase influence Pregnancy? ALP levels increase up to two times the normal level during pregnancy owing to placental release and foetal bone growth. However, extreme elevations in ALP beyond this point during pregnancy might be associated with perinatal complications [4, 5].
Alkaline phosphatase and γ-glutamyl transferase levels are elevated. Diagnosis relies on clinical and ultrasound findings. No specific treatment exists for primary sclerosing cholangitis, but ursodeoxycholic acid and stabilization of cirrhosis, when present, have been associated with good outcome.
Review of the literature has linked markedly elevated serum ALP levels with adverse obstetric and perinatal outcomes, including preterm labor, hypertensive disorders of pregnancy and low birth weight.
In 10/12 (83%) cases, elevated ALKP levels were of placental origin; the rest had osteal origin. Median gestational age at delivery was 38 (range 35-41); four (19%) women had preterm delivery. Six patients (29%) had gestational diabetes mellitus and six (29%) had hypertensive disorders.
We report a case of a pregnant woman with an incidental discovery of an extremely high isolated ALP serum concentration which had no fetomaternal outcomes, as levels returned to baseline in the postpartum.
Some causes of elevated alkaline phosphatase include Paget disease, healing fractures, acromegaly, osteogenic sarcoma, liver or bone metastases, leukemia, myelofibrosis, rickets, osteomalacia, hypervitaminosis D , cholestasis of pregnancy, biliary obstruction, hyperthyroidism, infiltrative liver diseases (eg, sarcoid, TB, amyloidosis, abscess ...