High aminotransferase during pregnancy may be caused by liver injury during pregnancy, HELLP syndrome, fatty liver in pregnancy, intrahepatic cholestasis in pregnancy and so on. 1. Liver injury during pregnancy: with the increase of gestational weeks, the burden on the organs of the whole body of the pregnant woman will also increase, when liver injury will cause transaminase elevation, but coagulation function, blood routine, liver, gallbladder, spleen and pancreas ultrasonography is normal, there is no obvious gastrointestinal symptoms, which can be combined with the history of the disease and liver function tests to assist in the diagnosis. 2. HELLP syndrome: it is a serious complication of preeclampsia, which can endanger the life of mother and child. It is mainly characterized by hemolysis, elevated liver enzymes and lowered platelets, and pregnant women with a history of preeclampsia can be accompanied by epigastric pain, nausea, and vomiting, etc. The combination of medical history, clinical manifestations, and blood routine, cardiac enzyme profile, and liver function tests can help in the diagnosis. 3. Fatty amine in pregnancy: it is a serious complication of pregnancy, mainly manifested by persistent gastrointestinal symptoms, such as nausea, vomiting, epigastric pain, progressive jaundice, etc., and also cause transaminase elevation, and there are abnormalities in liver and kidney function, coagulation function, blood routine, blood glucose, and liver and gallbladder ultrasound, etc. Combining with medical history, clinical manifestations, and laboratory tests can help diagnose the disease. 4. Intrahepatic cholestasis of pregnancy: it is a unique complication of pregnancy, which can also cause transaminase elevation, mainly manifested as itching, jaundice and other symptoms, laboratory tests, serum bile acids are elevated, combined with the history, clinical manifestations and liver function tests can assist in the diagnosis. When transaminases are high during pregnancy, it is necessary to identify the cause under the guidance of a doctor and deal with it promptly.