From the Guidelines

Liver Function Tests (LFTs) timing based on delivery is dependent on the specific liver condition and gestational age.

HELLP syndrome: delivery should be triggered after diagnosis and stabilization, regardless of gestational age 1
Acute Fatty Liver of Pregnancy (AFLP): no reason to delay delivery after diagnosis, with consideration of expedited vaginal induction if fetal demise has occurred 1

Intrahepatic Cholestasis of Pregnancy (ICP) with high bile acids (≥100 μmol/L): delivery should be planned between 35-36 weeks due to increased risk of sudden fetal demise 1
ICP with lower bile acid levels: delivery can be delayed until >37 weeks 1
Pre-existing liver disorders: delivery can be planned in early term (e.g., 38-39 weeks) 1

Gestational age: delivery timing should be based on gestational age and fetal condition 1
Maternal condition: delivery timing should be based on severity of maternal condition and cervical status 1
Fetal condition: delivery timing should be based on fetal condition and risk of adverse outcomes 1

Ursodeoxycholic acid: should be considered for treatment of maternal pruritus in ICP, and may reduce risk of spontaneous preterm birth and stillbirth 1
Misoprostol: may be less suitable for women with hepatic failure due to liver metabolism 1

From the Research

The timing of Liver Function Tests (LFTs) based on delivery is a critical aspect of managing patients with preeclampsia with severe features 2.
According to the American College of Obstetricians and Gynecologists' criteria, elevated liver enzymes (aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥2x the upper limit of normal) are considered a diagnostic criterion for severe features of preeclampsia 2.
However, the study found that above threshold LFTs are not independently associated with an increased risk of adverse maternal or neonatal outcomes among patients with preeclampsia with severe features 2.
Adverse neonatal outcomes in patients with preeclampsia with severe features and above threshold LFTs are driven by earlier gestational age at delivery, suggesting that the timing of delivery is crucial in these cases 2.
Prospective studies are needed to guide delivery timing in patients with preeclampsia and elevated liver enzymes 2.

LFTs are a helpful screening tool for detecting hepatic dysfunction, but no single test is sufficient to provide a complete estimate of liver function 3.
The interpretation of LFTs can be challenging, and clinicians often face difficulty in interpreting the results 3.
Automated investigation algorithms, such as intelligent liver function testing (iLFT), can help increase the early diagnosis of liver disease and improve the quality of care 4, 5.

The iLFT system has been shown to be cost-effective and can help identify the cause of liver dysfunction, allowing for early diagnosis and management of liver disease 4, 5.
The use of iLFT can help break down the barrier between clinical and laboratory medicine and offer solutions to many of the challenges experienced in modern healthcare systems 5.