DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20170560

Liver ailments in pregnancy: our experience

Uttara Aiyer Kohli, Atul Seth, Sanjay Singh, Rajesh Mishra

Abstract


Background: The spectrum of liver disease is varied and is associated with increased maternal and perinatal morbidity and mortality when pregnancy coexists with the liver disease. This study aims to analyze the incidence, spectrum, clinical presentation and outcome of liver diseases complicating pregnancy

Methods: A retrospective cohort study was conducted and data was collected from the hospital records of obstetric cases diagnosed with liver disease complicating pregnancy in a tertiary care hospital, over a period of two years.

Results: A total 146 cases of liver diseases complicating pregnancies were recorded out of 5018 deliveries (2.9%). Intrahepatic cholestasis of pregnancy (n=52, 35.62%) and severe preeclampsia (n=47, 32.19%, with HELLP n=8, 5.48%) accounted for majority of cases. The incidence of chronic hepatitis B infection was 20.56% (n=30). There were two maternal deaths (1.37%) attributed to severe post-partum HELLP and severe preeclampsia with multi organ failure.

Conclusions: Liver diseases in pregnancy have a non-specific presentation and may be associated with a wide range of conditions, early diagnosis and timely appropriate intervention can help reduce the mortality and morbidity.


Keywords


AFLP, HELLP, Liver, Preeclampsia, Pregnancy

Full Text:

PDF

References


Tran TT, Ahn J, Reau NS. ACG clinical guideline: liver disease and pregnancy. Am J Gastroenterol. 2016 ;111:176-94.

Pandey CK, Karna ST, Pandey VK, Tandon M. Acute liver failure in pregnancy: challenges and management. Indian J Anaesthesia. 2015;59(3):144-9.

Sahai S, Kiran R. Acute Liver Failure in Pregnancy: causative and prognostic factors. Saudi J Gastroenterol. 2015;21(1):30-4.

Ch’ng CL, Morgan M, Hainsworth I, Kingham JG. Prospective study of liver dysfunction in pregnancy in Southwest Wales. Gut. 2002;51:876-80.

Dsouza AS, Gupta G, Katumalla FS, Goyal S. Maternal and fetal outcome in liver diseases of pregnancy- A tertiary hospital experience. Int J Sci Res Pub. 2015;5(9):1-4.

Sharma S, Aherwar R, Jawade S. Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2016;5:1084-7.

Acharya N, Acharya S, Shukla S, Athvale R, Shaveta. Study of Jaundice in Pregnancy. Glb J Med Res. 2013;13:25-9.

Rathi U, Bapat M, Rathi P, Abraham P. Effect of liver disease on maternal and fetal outcome in pregnancy- a prospective study. Indian J Gastroenterol. 2007;26; 59-63.

Hay JE. Liver disease in pregnancy. Hepatology. 2008;47:1067-76.