Publication:

Fetomaternal outcomes in liver disorders of pregnancy: a retrospective study from South India

Background Liver disorders in pregnancy are rare but can cause life-threatening maternal and fetal complications. They arise from physiological, pregnancy-specific, or coincidental systemic diseases. This study aimed to analyze the etiological spectrum, biochemical profile, and fetomaternal outcomes among pregnant women with hepatic dysfunction at a tertiary-care center in Tamil Nadu.

Methods A retrospective observational study was conducted between June 2024 and May 2025 in the department of obstetrics and gynecology, Government Medical College, Tiruvannamalai. All pregnant women with clinical or biochemical evidence of liver dysfunction were included. Data on symptomatology, etiology, biochemical parameters, complications, and fetomaternal outcomes were recorded. Statistical analyses included χ2 tests and ROC curve analysis of serum bilirubin, transaminases, and LDH as predictors of maternal complications.

Results Among 12,542 deliveries, 65 (0.5 %) women had liver disorders. Mean age was 25 years; 73.8% presented in the third trimester. The commonest causes were viral hepatitis (52.3%), HELLP syndrome (16.9%), and hyperemesis gravidarum (13.8%). Maternal complications included postpartum hemorrhage (23%), DIC (9%), and hepatorenal syndrome (15%). There were no maternal deaths. Of 57 live births, 12% were preterm and three fetuses had intra-uterine death. ROC analysis showed LDH (AUC 0.82) as the best predictor of adverse maternal outcomes.

Conclusions Liver disease in pregnancy remains a significant threat to fetomaternal health. Elevated LDH serves as a reliable biochemical marker of severity. Early diagnosis and multidisciplinary management are key to preventing mortality.