Liver disorders in pregnancy: A fetomaternal outcome

Abstract

Liver disease is a potentially serious complication seen in pregnancy occurring more in developing countries. The advances in understanding of the diseases with timely diagnosis and management have resulted in a significant reduction in the adverse outcome occurring both in the mother and the fetus. Aim and objective: To study the fetomaternal outcome due to the various causes of liver diseases in pregnancy. Materials and methods: • Study design: Observational prospective study. Study setting: The study was conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode from March 2016 to September 2017, a total of 18 months. • Study subjects: Pregnant patients with liver diseases who presented as jaundice and attended the Department of Obstetrics and Gynaecology during the study period were included in the study. Nonpregnant ladies with jaundice were excluded from the study. • Methodology: A detailed history, clinical examination, and necessary investigations were done for all cases. Results: The observations from this study were as follows: The total number of deliveries in this period was 24060. The number of cases with liver diseases complicating pregnancy was 52. Thus the incidence of liver diseases complicating pregnancy was 0.22%. In this study, out of the 52 cases of liver diseases complicating pregnancy, 18 (34.6%) were found to be due to hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Maximum number of cases were between 34 weeks and 37 weeks of gestation (40.4%). Of the total 52 cases, 23 underwent cesarean delivery and 29 had vaginal delivery. There was one case of maternal death which was due to fulminant hepatic failure in a case of hepatitis A. The perinatal mortality rate in this study was 122 per 1,000 cases of liver diseases. Conclusion: Early diagnosis and prompt management of cases may decrease the perinatal and maternal morbidity as well as mortality to a greater extent.