Document Detail


Prospective evaluation of abnormal liver function tests in pregnancy.
MedLine Citation:
PMID:  16737048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Abnormalities in liver function tests (LFT) during pregnancy are a commonly encountered problem often associated with serious consequences especially when it occurs in the third trimester. The spectrum of abnormal liver functions in pregnancy can be fairly wide and diagnostic work up often challenging. There is insufficient prospective data on the spectrum and outcome of liver disease in pregnant population from south India. This study was performed to assess the causes of deranged liver function in the pregnant population and also to prospectively determine the outcome of liver dysfunction in pregnancy. All abnormal LFT results observed in serum samples from pregnant patients attending the obstetric unit of our hospital from January 2003 to January 2005 were evaluated and prospectively followed throughout pregnancy. Laboratory investigations included coagulation profile, renal function tests, serology for viral markers (HBsAg, anti-HCV, IgM anti-HEV and IgM anti-HAV) and other relevant biochemical tests. In those with liver dysfunction in the third trimester the maternal and perinatal outcome was evaluated. A total of 125 patients were identified with abnormalities in LFT results during this period. The majority of causes were related to pregnancy specific conditions (57.6%). Most episodes of abnormal LFT occurred in the third trimester (59.2%). Hyperemesis gravidarum (55.8%) and viral hepatitis (47%) were the most common causes of abnormal LFT in the first and second trimesters respectively. HELLP (28.3%) and AFLP (14.8%) were the most common causes of abnormal LFT in the third trimester. There were no mAternal deaths due to liver dysfunction in the first or second trimester. Liver dysfunction in the third trimester (74 patients) was associated with serious consequences. DIC was the most common complication (20.2%). The overall and perinatal mortality was 20.2% and 24.6% respectively. AFLP and HELLP syndromes were associated with poor maternal and fetal outcome. We conclude that liver dysfunctions were directly related to pregnancy in the majority of patients especially in the third namely trimester. Incidence of the most serious conditions AFLP and HELLP syndromes is much greater than what has been reported and is often associated with a high maternal mortality and poor perinatal outcome.
Authors:
K Harish; R Nitha; R Harikumar; K Sunil Kumar; Thomas Varghese; N S Sreedevi; K Bushrath; K Sandesh; J Tony
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Tropical gastroenterology : official journal of the Digestive Diseases Foundation     Volume:  26     ISSN:  0250-636X     ISO Abbreviation:  Trop Gastroenterol     Publication Date:    2005 Oct-Dec
Date Detail:
Created Date:  2006-06-01     Completed Date:  2006-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8107122     Medline TA:  Trop Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  188-93     Citation Subset:  IM    
Affiliation:
Calicut Medical College, Kozhikode 673 008, Kerala. dr_harishk@yahoo.co.in
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
India / epidemiology
Liver Diseases / diagnosis,  epidemiology*
Liver Function Tests
Pregnancy
Pregnancy Complications / diagnosis,  epidemiology*
Pregnancy Outcome
Pregnancy Trimesters
Prospective Studies

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