Publication:

Study of patients with liver dysfunction during pregnancy and their maternal and perinatal outcomes

Background Liver dysfunction in pregnancy can be associated with maternal and perinatal morbidity and mortality, therefore early recognition and timely management is of paramount importance to improve the outcome. The studies related to liver dysfunction in pregnancy and its outcome are sparse from this part of India and are retrospective in nature, so present study was planned.

Methods A total of 80 pregnant patients with liver dysfunction were enrolled as per the inclusion criteria after taking informed consent. Patients were investigated depending on the symptoms and pregnancy related complications with an aim to know the probable cause of liver dysfunction. Maternal and perinatal outcomes were noted in these patients.

Results Intrahepatic cholestasis of pregnancy was the most common cause of deranged liver function tests (71.3%) followed by HELLP syndrome (21.3%), viral hepatitis (6.3%) and AFLP (1.3%) respectively. The most common maternal complication seen was preterm labour (33.8%) followed by thrombocytopenia (11.3%), postpartum hemorrhage (7.5%), vaginal wall hematoma (7.5%) and coagulopathy (3.8%). 2 patients (2.5%) required ICU admission and both patients expired due to fulminant hepatic failure. The most common fetal complication was prematurity (33.8%). Intrauterine fetal demise occurred in 10% of the patients and there were 12.5% perinatal deaths observed in our study.

Conclusions The commonest cause of liver dysfunction in our study was IHCP (71.3%) followed by HELLP syndrome (21.3%). In spite of multidisciplinary approach, liver dysfunction during pregnancy was associated with high maternal and perinatal morbidity and mortality.