| Prospective study of liver dysfunction in pregnancy in Southwest Wales. | |
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MedLine Citation:
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PMID: 12427793 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Liver dysfunction in pregnancy has serious consequences. Its frequency and characteristics have not been systematically documented in Britain. We have prospectively determined incidence, causes, and outcome of liver dysfunction in pregnancy in an obstetric unit in Southwest Wales, UK. METHODS: A central laboratory identified all abnormal liver tests (bilirubin >25 micro mol/l, aspartate transaminase >40 U/l, or gamma glutamyl transpeptidase >35 U/l) from patients in antenatal clinics and wards of an obstetric unit serving a population of 250 000. Patients with abnormal liver tests were assessed and followed throughout and after pregnancy [corrected]. Medical advice was provided to obstetric teams. FINDINGS: There were 4377 deliveries during the 15 month study. A total of 142 patients had abnormal liver tests. There were 206 contributing diagnoses, the great majority being pregnancy specific. Among the most important were pre-eclampsia (68), HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome (30), obstetric cholestasis (23), hyperemesis gravidarum (11), acute fatty liver of pregnancy (five), and hepatic infarct (one). Sepsis, postoperative factors, and placental pathology (51) were not uncommonly responsible but incidental or pre-existing hepatobiliary disease was infrequent (17). Sixty five patients were delivered early by induction or caesarean section because of liver dysfunction. Despite substantial liver related morbidity, there were no maternal deaths and only two intrauterine deaths. CONCLUSIONS: Liver dysfunction was seen in 3% of deliveries during a 15 month prospective study and was usually directly related to pregnancy with spontaneous recovery in the puerperium. Incidence of the most serious conditions, acute fatty liver of pregnancy and HELLP syndrome, was much greater than previously reported. Profound effects on maternal and infant health were observed but close medical and obstetric collaboration ensured low mortality. |
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Authors:
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C L Ch'ng; M Morgan; I Hainsworth; J G C Kingham |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gut Volume: 51 ISSN: 0017-5749 ISO Abbreviation: Gut Publication Date: 2002 Dec |
Date Detail:
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Created Date: 2002-11-12 Completed Date: 2002-12-17 Revised Date: 2010-12-28 |
Medline Journal Info:
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Nlm Unique ID: 2985108R Medline TA: Gut Country: England |
Other Details:
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Languages: eng Pagination: 876-80 Citation Subset: AIM; IM |
Affiliation:
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Department of Gastroenterology, Singleton Hospital, Swansea, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Apgar Score Fatty Liver / physiopathology Female Humans Hyperemesis Gravidarum / physiopathology Incidence Infant, Newborn Liver / physiopathology* Liver Diseases / etiology, physiopathology* Liver Function Tests Platelet Count Pre-Eclampsia / complications, physiopathology Pregnancy Pregnancy Complications / etiology, physiopathology* Pregnancy Outcome Prospective Studies Retrospective Studies Syndrome |
| Comments/Corrections | |
Comment In:
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Gut. 2011 Jan;60(1):138-9; author reply 139-40
[PMID:
20938054
]
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Erratum In:
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Gut. 2003 Feb;52(2):315. |
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