<s>[INST] Hi I want to know does pregnancy cause increase in sgot/sgpt/alkaline phosphatase levels. My ALT is 288, AST is 271 and alkaline phosp. is 277. what should be done.what medication are safe during pregnancy to reduce this. [/INST] You could potentially have HELLP syndrome. This a disease of pregnancy on the continuum with preeclampsia. In HELLP syndrome, we see elevated liver enzymes, as well as low platelets, elevated pressure, and frequently, protein in the urine. This can potentially be dangerous and progress to full blow eclampsia- seizure in pregnancy associated with elevated blood pressure. Eclampsia can be deadly. If you truly have suddenly elevated liver enzymes in pregnancy, you need to be evaluated immediately. You may need to be delivered emergently. Other potential causes of elevated liver enzymes in pregnancy are fatty liver of pregnancy, Intrahepatic cholestasis of pregnancy (you would have itching all over), hepatitis (food-born vs. blood-born), or it could be benign. I recommend you get a thorough evaluation at your delivery hospital today to make sure it's nothing serious. </s>