Study of fetomaternal outcomes in a tertiary care hospital related to liver disorders during pregnancy

Abstract

Introduction: Pregnancy-related liver diseases are significant medical conditions with a poor prognosis that present a challenge to both obstetricians and hepatologists. Around 3% of pregnancies worldwide and 3-5% of pregnancies in India are impacted by it. Numerous symptoms, including a yellowish discoloration of the sclera, black urine, anorexia, nausea, vomiting, and stomach pain, can be present. Hyperemesis gravidarum, preeclampsia, eclampsia with liver dysfunction, hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, intrahepatic cholestasis of pregnancy (IHCP), and acute fatty liver of pregnancy are among the specific liver illnesses associated with pregnancy. Methods: This prospective observational study was carried out at the SCB Medical College and Hospital in Cuttack, Department of Obstetrics and Gynecology. On the basis of the inclusion criteria, 85 prenatal cases were prospectively investigated. Those who underwent a thorough history and examination, clinical symptoms suggestive of liver disorders, all available LFTs, including LDH, as well as some more conclusive tests to help identify the underlying cause, were then monitored up until delivery in terms of the outcome for the maternal and the foetus. Results: There were 0.86% cases of hepatic problems during pregnancy. In the study group, 76.5% of cases appeared in the third trimester of pregnancy, 72.9% of cases were primigravida, and 90.59% of cases were between 20 and 30 years old. 76.4% of the participants in this study had a liver condition unique to pregnancy, of which 32.9% had pre-eclampsia, 11.7% had eclampsia, and 11.7% had HELLP syndrome. 16.4% had ICP, 2.3% had AFLP, and 1.1% had hyperemesis gravidarum. Morbidity was 34.12% and maternal mortality was 10.58%. Preterm 21.1%, stillbirth 38.82%, live birth 61%, and IUGR 24.7%. In 28.57% of cases, NICU admission is necessary. Conclusion: Poor outcomes for the maternal and the foetus are linked to abnormal liver function during pregnancy. Many pregnant women and their unborn children can be saved by routine prenatal screenings, liver problem diagnosis, and treatment.