A study of spectrum and outcome of liver diseases in pregnant women at BRD medical college

Abstract

Background: Different spectrum of liver disease can affect outcome of pregnancy. The incidence of liver disorders in pregnancy varies in different parts of the world. The present study was designed to see the incidence, spectrum, and outcome of liver disease in pregnancy.Methods: All pregnant women with deranged liver profile, attending antenatal clinic and labour room in the department of Obstetrics and Gynecology of BRD Medical College over the period of one year (August 2015 to July 2016) were included in the study. Enrolled cases were followed up till discharge in respect to maternal and fetal outcome.Results: Liver disease was found in 214 (2.37%) cases out of 9011 pregnancies. Pregnancy specific liver disease was the most common type (85.98%). Among pregnancy specific liver disease Hypertensive disorders of pregnancy was the commonest abnormality (66.35%). Rest were Cholestasis, Acute viral hepatitis, Chronic liver disease, Hyperemesis gravidarum, Acute fatty liver of pregnancy. Out of 214, 22 patients dropped out. Overall maternal and perinatal mortality were 13.02% and 29.17% respectively.Conclusions: Liver disease in pregnancy is not uncommon and it can seriously affect pregnancy outcome if not treated properly on time. Early diagnosis (by clinical suspicion and blood investigation) and timely intervention can improve maternal and fetal outcome in pregnancy with liver disease.

Pregnancy outcomes in women with liver disease: Is pregnancy safe? A cross-sectional study

“…Nowadays, the overall perinatal mortality is decreased because of the better understanding of physiologic changes during the pregnancy, team working, and ontime intervention. In agreement with previous studies, the prevalence of the liver disease in pregnant women in our study was 1.58% (4,8).…”

“…The neonatal mortality in this study was 9.1%. The rate of neonatal mortality in developing countries such as India was reported as 29.17% (4). We found no maternal mortality due to liver diseases.…”

“…International Journal of Reproductive BioMedicine Pregnancy outcome, liver disease This study showed that the mean age of the pregnant women with liver disease was 31 ± 6 yr. Similarly to our study, Tiwari et al assessed a young study population with aged range of 20 to 29 years.They believed that a variety of liver tests is very important before pregnancy for this age range, especially if there is a history of past medical diseases, such as chronic hypertension, diabetes mellitus, autoimmune hepatitis, and liver disease (4). In our study, 25.5% of our participants had a history of hypertension and 10.9% had previous liver disease.…”

“…The relationship between the gestational age at the time of delivery and neonatal prematurity, has been studied in several studies (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The mean gestational age in our study was 244.05 ± 27.357 days, and the preterm birth was detected in 64.5% of women that is high and corresponds with previous studies (1)(2)(3)(4)(5)(6)(8)(9)(10)(11)(12)(13)(14)(15). In the study of Carballo et al, GA was 35 wk and 6 days with 10% premature delivery.…”

“…Some cases are further complicated by HELLP, partial HELLP syndrome [H (hemolysis), EL (elevated liver enzymes), LP (low platelet count)], and eclampsia. Delivery is the only definitive therapy in such conditions, since many maternal complications may occur, including placental abruption, renal failure, subcapsular hematomas, and hepatic rupture (2)(3)(4)(5)(6). Cholestasis of pregnancy, which is typically presented by generalized pruritus, predominately on the palms of the hands and the soles of the feet, and the condition is worse at night, may be associated with liver dysfunction (7)(8)(9)(10)(11)(12)(13)(14).…”