DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204288

Effect of abnormal liver function test on maternal and perinatal outcome in pregnancy: observational study

Rashmi Tripathi, Madhuri Brahmane, Sapna Bajaj Jain

Abstract


Background: The present study was conducted with the objective to assess the spectrum of liver disease in pregnancy, and its course and effect on maternal and fetal outcomes.

Methods: The present study was conducted as a prospective follow up study in the department of Obstetrics and Gynaecology, J. K. Hospital for a period of 1 year. The pregnant women between the ages of 18-35 years presenting with symptoms suggestive of underlying liver disease were selected. Socio demographic details and clinical history was obtained from all the participants and they were subjected to liver function test (LFT). All patients were followed till 2 weeks post-partum period. The maternal and fetal outcomes were noted.

Results: The following results were obtained: pregnancy-induced hypertension (PIH) was the most common cause of abnormal LFT (46.66%), about 57.5% patients delivered at term, 63.3% patients delivered vaginally, mostly cases delivered a term healthy neonate between 2.5-3.0 kg weight with Apgar score >7 at 5 minutes after birth and maternal complications were seen in 10.82% cases.

Conclusions: Our study shows that though liver disease is uncommon in Indian pregnant women, but it is associated with high maternal and perinatal morbidity. A high index of suspicion of liver disease, early diagnosis, prompt referral to a higher centre when required, appropriate supportive management, and a proactive policy of early delivery when indicated may improve the maternal and fetal outcomes in pregnant women with liver disease. Thus LFT should be conducted as a routine investigation in all pregnant females during first and second trimester.


Keywords


Acute fatty liver of pregnancy, Hyperemesis gravidarum, Liver function test, Pre-eclampsia

Full Text:

PDF

References


Hay JE. Liver disease in pregnancy. Hepatol. 2008;47(3):1067-76.

Rathi U, Bapat M, Rathi P, Abraham P. Effect of liver disease on maternal and fetal outcome-a prospective study. Ind J Gastroenterol. 2007;26(2):59.

García-Romero CS, Guzman C, Cervantes A, Cerbón M. Liver disease in pregnancy: Medical aspects and their implications for mother and child. Ann Hepatol. 2019;18(4):553-62.

Mitra AK, Patki PS, Mitra SK. Liver disorder during pregnancy and their management. Antiseptic. 2008;105(4):193-6.

Mishra N, Mishra VN, Thakur P. Study of abnormal liver function test during pregnancy in a tertiary care hospital in Chhattisgarh. J Obstet Gynecol India. 2016;66(1):129-35.

Sumangali PK, Kurian S. Study of abnormal liver function tests in pregnancy in a tertiary centre in North Kerala. Int J Res Med Sci. 2017;5:5193-6.

Dang A, Agarwal N, Bathla S,Sharma N, Balani S. Prevalence of liver disease in pregnancy and its outcome with emphasis on obstetric cholestasis: an Indian scenario. J Obstet Gynecol India. 2010;60(6):413-8.

Yelmizaitun O, Jeriah I, Huraini H, Mazlina MN, Zailina TN, NorashidahA, et al. Fetal-maternal outcome among pregnancy induced hypertension mothers attending klinik kesihatan rantau panjang in 2010. Available at: http://www.jknkelantan.moh.gov.my/v3/uploads/files/pdfs/khc2011/ OP_24.pdf. Accessed on: 14 January 2016.

Sultana R, Sarwar I, Fawad A, Noor S, Bashir R. Neonatal outcome in obstetric cholestasis patients at Ayub Teaching Hospital Abbottabad. J Ayub Medical College Abbottabad. 2009;21(4):76-8.

Bolukbas FF, Bolukbas C, Horoz M, Ince AT, Uzunkoy A, Ozturk A, et al. Risk factors associated with gallstone and biliary sludge formation during pregnancy. J Gastroenterol Hepatol. 2006;21(7):1150-3.

Singhal S, Deepika A, Nanda S. Maternal and perinatal outcome in severe pre-eclampsia and eclampsia. South Asian Federation of Obstetrics and Gynecology. 2009;1(3):25-8.

Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Obstetric cholestasis, outcome with active management: a series of 70 cases. BJOG. 2002;109:282-8.

Mbachu II, Udigwe GO, Okafor CI, Umeonunihu OS, Ezeama C, Eleje GU. The pattern and obstetric outcome of hypertensive disorders of pregnancy in Nnewi, Nigeria. Niger J Med. 2013;22(2):117-22.

Ch’Ng CL, Morgan M, Hainsworth I, Kingham JGC. Prospective study of liver dysfunction in pregnancy in Southwest Wales. Gut. 2002;51(6):876-80.

Murphy DJ, Stirrat GM, Heron J. (2002). The relationship between Caesarean section and subfertility in a population-based sample of 14 541 pregnancies. Human Reproduction. 2002;17(7):1914-7.

Kumar S, Bansal D, Hota D, Jain M, Singh P, Pandey BL. (2014). Assessment of clinical outcomes and prescribing behavior among inpatients with severe preeclampsia and eclampsia: an Indian experience. Indian J Pharmacol. 2014;46(1):18.

Veenendaal MV, van Abeelen AF, Painter RC, van der Post JA, Roseboom TJ. (2011). Consequences of hyperemesis gravidarum for offspring: a systematic review and meta‐analysis. BJOG: Int J Obstet Gynaecol. 2011;118(11):1302-13.