Study of liver Disorders during pregnancy and fetomaternal outcome in a tertiary care hospital

Abstract

Background: Liver disease in pregnancy encompasses a spectrum of diseases which causes abnormal liver function tests. The liver disorders are associated with significant maternal and foetal morbidity and mortality. The present study was done with objective to study incidence, clinicopathological correlation of liver disorder during pregnancy and its impact on maternal and foetal outcome.Methods: This prospective observational study was conducted in Department of Obstetrics and Gynaecology, NSCB Medical College Jabalpur. Eighty-five antenatal cases, on the basis of inclusion criteria were studied prospectively. Those subjected to detailed history and examination, clinical symptoms suggestive of liver disorders followed by all available LFTs including LDH along with some more definitive tests to aid identification of underlying cause and followed up till delivery in terms of maternal and foetal outcome. Results: The incidence of the liver disorders in pregnancy was 0.86%. In study group, 76.5% cases were between 20-30 years of age,72.9% cases were primigravida and 90.59% cases presented in third trimester of pregnancy. In this study, 76.4% presented with pregnancy specific liver disorder, of these 32.9% had pre-eclampsia, 11.7% had eclampsia, 11.7% had HELLP syndrome. 16.4% with ICP, AFLP 2.3%and Hyperemesis gravidarum in 1.1% cases. Maternal mortality was 10.58% and morbidity was 34.12%. Live birth 61%, still birth 38.82%, preterm 21.1% and IUGR 24.7%. NICU admission required in 28.57% cases. Conclusions: Regular antenatal check-up, screening and diagnosing liver disorder at an earliest, proper treatment and timely referral to higher centres can save the lives of many mothers and foetuses.