| Abnormal liver function tests in the symptomatic pregnant patient: the local experience in Singapore. | |
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MedLine Citation:
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PMID: 15098635 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: The causes of abnormal liver function tests in pregnancy are varied and may or may not be pregnancy-related. Often, the diagnosis can be difficult. This study looked at the causes of deranged liver function tests in obstetric patients with significant symptoms and signs. MATERIALS AND METHODS: Data from 50 cases of abnormal liver function tests in pregnant patients, who presented from 1998 to 2001, were analysed. Their presenting symptoms included persistent vomiting (48%), pruritus (14%), jaundice (26%), upper abdominal discomfort (24%) and hypertension (46%). RESULTS: Pregnancy-related causes accounted for 84% of the abnormal liver function tests. Abnormal liver function tests occurred more frequently in the first (34%) and third (58%) trimesters than in the second trimester (8%). Hyperemesis gravidarum (94%) and partial haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome (31%) were the commonest causes in the first and third trimesters respectively. Hepatitis B flare resulted in 2 maternal deaths. Seven patients with pre-eclampsia toxaemia, acute fatty liver of pregnancy or partial/complete HELLP syndrome had their liver function tests measured sequentially before and after delivery. All of them showed rapid improvement postpartum with their alanine aminotransferase (ALT) dropping 50% within 3 days. CONCLUSIONS: The majority of patients with abnormal liver function tests had a cause related to pregnancy, and pregnancy-related causes in the third trimester improved rapidly postpartum. Hepatitis B flare was a significant non-obstetric cause leading to maternal mortality. This diagnosis must therefore be considered in ethnic groups where the incidence of chronic hepatitis B infection is high, especially in chronic hepatitis B carriers with suspected pregnancy-related disease who deteriorate postpartum. |
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Authors:
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H Y Wong; J Y L Tan; C C Lim |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of the Academy of Medicine, Singapore Volume: 33 ISSN: 0304-4602 ISO Abbreviation: Ann. Acad. Med. Singap. Publication Date: 2004 Mar |
Date Detail:
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Created Date: 2004-04-21 Completed Date: 2004-07-15 Revised Date: 2009-02-26 |
Medline Journal Info:
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Nlm Unique ID: 7503289 Medline TA: Ann Acad Med Singapore Country: Singapore |
Other Details:
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Languages: eng Pagination: 204-8 Citation Subset: IM |
Affiliation:
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Gastroenterology Unit, Department of General Medicine, Tan Tock Seng Hospital, Singapore. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Choledocholithiasis / metabolism* Female Humans Liver Diseases / metabolism* Liver Function Tests* Postpartum Period / metabolism Pregnancy Pregnancy Complications / metabolism* Retrospective Studies Singapore Typhoid Fever / metabolism* |
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