Comparison of Liver Function Tests in Normal Pregnancy with Non-pregnant Matched Controls

Abstract

Background: Change of liver biochemical profiles is normal during pregnancy. It is almost impossible to understand disease processes that can threaten women during pregnancy without understanding normal physiological change. Aim of this study is to evaluate changes in serum liver function tests in normal pregnant women in first, second and third trimester.
 Material and Methods: The cross-sectional comparative study was carried out in the Department of Obstetrics & Gynaecology of Rajshahi Medical College Hospital, Bangladesh in 2019. This study consists of 90 pregnant women and 90 matched control. Among the 90 pregnant women, 30 were in first trimester, 30 were in second trimester and 30 were in third trimester. Blood samples were taken for routine liver function and protein profiles
 Results: Serum total and direct bilirubin concentrations were significantly lower in second and third trimester. The mean ALP level was slightly increased in 2nd trimester and drastically increased in 3rd trimesters during pregnancy. Serum ALT and AST activity was significantly increased in third trimester. No significant change in serum total proteins concentration, but serum albumin concentration was significantly lower and serum globulin concentration was significantly higher in all three trimester. Serum albumin/globulin ratio was significantly reduced in second and third trimester.
 Conclusion: Relative values of various liver function tests during gestational trimesters appear to be the best guide to confirm the diagnosis and treatment strategies. Thus, gynecologists should routinely monitor liver function tests in all gestational trimesters to avoid the future complications to mother and offspring.
 TAJ 2020; 33(1): 17-24

Hormonal aspects of skin hyperpigmentation in healthy Kurdish primigravida women in Erbil City

“…Biological alterations in alkaline phosphatase value happen with regularity during the reproductive cycle. The greatness of alteration corresponds largely to anatomic growth and development (Khatun et al, 2020). The result of total bilirubin and direct bilirubin in the current study agrees with previous investigations (Mishra et al, 2016;Suresh and Radfar, 2004) show a significant elevation from the first to the third trimester.…”

“…The current results indicate that albumin level decreased in the second and third trimesters and total proteins in last trimester compared with the first trimester. The present result agrees with studies of (Khatun et al, 2020;Venugopal and Rajamma 2015;Gohel et al, 2013;Suresh and Radfar, 2004), who showed a decline of serum albumin in the first ten weeks of pregnancy and slightly decreased toward term because there was a high plasma volume, the yields elevate in plasma volume proceeds from 50 cc at ten weeks pregnancy to 800 cc at 20 weeks. Also, excessive loss of urinary excretion may explain the fall in blood albumin level through late gestation (Khatun et al, 2020;Gohel, et al, 2013;Jamjute et al, 2009).…”

“…The present result agrees with studies of (Khatun et al, 2020;Venugopal and Rajamma 2015;Gohel et al, 2013;Suresh and Radfar, 2004), who showed a decline of serum albumin in the first ten weeks of pregnancy and slightly decreased toward term because there was a high plasma volume, the yields elevate in plasma volume proceeds from 50 cc at ten weeks pregnancy to 800 cc at 20 weeks. Also, excessive loss of urinary excretion may explain the fall in blood albumin level through late gestation (Khatun et al, 2020;Gohel, et al, 2013;Jamjute et al, 2009). On the other hand, the result of ALT, AST, total bilirubin, and direct bilirubin were dissimilar with findings documented (Khatun et al, 2020;Venugopal and Rajamma 2015;Gohel, et al, 2013) they showed serum ALT, AST concentration significantly high while serum total bilirubin, and direct bilirubin concentration as gestation advanced were due to a phenomenon called hemodilution could be responsible for the change in serum liver enzymes or liver damage.…”

“…Also, excessive loss of urinary excretion may explain the fall in blood albumin level through late gestation (Khatun et al, 2020;Gohel, et al, 2013;Jamjute et al, 2009). On the other hand, the result of ALT, AST, total bilirubin, and direct bilirubin were dissimilar with findings documented (Khatun et al, 2020;Venugopal and Rajamma 2015;Gohel, et al, 2013) they showed serum ALT, AST concentration significantly high while serum total bilirubin, and direct bilirubin concentration as gestation advanced were due to a phenomenon called hemodilution could be responsible for the change in serum liver enzymes or liver damage. Similar results found previously by (Mishra et al, 2016;Venugopal and Rajamma 2015;Gohel, et al, 2013;Tran 2006) reporting shifts in protein level and change gradually throughout gestation because the metabolic demands increased due to physiological and hormonal changes in the mother and growth of the fetus.…”

“…Similar results found previously by (Mishra et al, 2016;Venugopal and Rajamma 2015;Gohel, et al, 2013;Tran 2006) reporting shifts in protein level and change gradually throughout gestation because the metabolic demands increased due to physiological and hormonal changes in the mother and growth of the fetus. Further explanation is that during gestation, micronutrients deficiencies may have severe consequences for pregnancy outcomes and, as a resulting decline, blood contents of proteins, vitamins and minerals (Khatun et al, 2020;Venugopal and Rajamma 2015;Guerra et al, 2009). The present study shows significantly higher alkaline phosphatase values in the third trimester and total bilirubin increased only in the second trimester compared with the first trimester.…”