A study of liver disorder and its consequences in pregnant women with jaundice in tertiary care centre in Belgaum, Karnataka, India

Abstract

Pregnancy with jaundice is regarded as high risk pregnancy so it is considered very important sign during antenatal check up. Incidence of jaundice in pregnancy is 0.4-0.9/1000 in India. It complicates 3-5% of pregnancies and is one of the important causes of maternal and neonatal morbidity and mortality worldwide. The normal physiological and hormonal profiles may alter throughout the pregnancy. The present retrospective study was carried out in the Department of Obstetrics and Gynecology, KLE's Dr. Prabhakar Kore Hospital and research centre from September 2011 to August 2012 to determine the causative factors responsible for jaundice in pregnant women and to assess its consequences in pregnancy. During this retrospective study of 3 years, 9,612 deliveries were conducted. Among them 9,167 were live birth and 445 were stillbirth. Overall 37(0.4%) women had clinical and biochemical evidences of jaundice. Their mean age was 24.78±3.66 years and the mean period of gestation (34.7±3.42 weeks). Among them predominant cause of jaundice was HELLP 24(64.86%) followed by acute viral hepatitis and Leptospirosis 5(13.51%) of each. Severe PIH was the most common co-morbid conditions observed in 20(54.05%) of the pregnant women. And the commonest cause of maternal mortality 15(53.57%) was HELLP followed by severe anaemia 3(10.75%). Among 37 births, 53.85% were live births, 28.21% were fresh still births and 17.95% were macerated still births. Among the 53.85% of live births, foetal mortality was seen in 4.76%. Pregnancy with liver disorder results in very high foetal as well as maternal morbidity and mortality. HELLP was found to be the predominant cause of Jaundice and associated mortality in pregnancy. It might cause mild to severe complication in pregnancy. Pregnancy with liver disorder results in high foetal as well as maternal morbidity and mortality. Thus early diagnosis and proper management is essential to reduce the high maternal mortality in pregnant women with jaundice.