Alan Karovitch
Internal medicine physician and obstetric medicine specialist at The Ottawa Hospital and University of Ottawa, with expertise in thrombosis and high-risk pregnancy care.
1
APPEARANCES
1
PODCASTS
Jun 16, 2026
speaker_1HOST
So with myself, Dr. Karovich, how would you approach this patient and what investigations would you send?
Alan KarovitchGUEST
So she's presenting with significant hepatocellular abnormalities, not our usual.
Alan KarovitchGUEST
And like everything in medicine, I think about specific obstetric causes and non-obstetric causes.
Alan KarovitchGUEST
So the three big things in obstetrics for liver dysfunction would be colostasis of pregnancy, which would not fit with this story, and those elevated enzymes.
Alan KarovitchGUEST
acute fatty liver of pregnancy, which you need to think about when those LFTs are so elevated, but there's usually quite clear concomitant liver dysfunction.
Alan KarovitchGUEST
Although her bilirubin is high, they often have a coagulopathy, they're often hypoglycemic, and they often have very severe symptomatology.
Alan KarovitchGUEST
And it's usually, I can't remember what gestational age you said, but it's usually quite a bit later in the pregnancy, well into the third trimester.
6 MINS LATER
speaker_1HOST
And so, Dr. Haravich, what would you say are some key take-home points for this case discussion?