English

Abstract

INTRODUCTION: OBJECTIVES: 1) To study maternal and fetal outcome among obstetric patients with deranged liver function tests. 2) To study the relationship between type of liver disease based on etiology and maternal and fetal outcome METHODS: 3 years prospective and retrospective study was carried out from Jan 2011 to Jan 2014 at rural medical Centre. 40 cases of pregnancy with deranged liver function tests were analyzed for incidence, maternal and fetal outcome. RESULTS: 1) Incidence of liver disease during pregnancy was 1.6%.in our study. 2) Majority of causes of jaundice were pregnancy specific. 3) Common causes of deranged liver function tests in the pregnancy were pregnancy induced hypertension with HELLP syndrome (37%), acute fatty liver of pregnancy (37%) and viral hepatitis (20%). 4) Overall maternal and perinatal mortality found in our study were 17.5% and 35% respectively. 5) Majority cases of HELLP & acute fatty liver of pregnancy were young primes (20-30years) at 32-34 weeks of gestation. 5) All cases of HELLP were associated with pregnancy induced hypertension. 6) Disseminated intravascular coagulation was most common morbidity. 8) 14 cases (56%). 7) Maternal mortality was highest 35% in acute fatty liver of pregnancy which reduces to 18% if unbooked cases with uncorrected disseminated intravascular coagulation are excluded. 8) Perinatal mortality was highest with HELLP syndrome (50%). CONCLUSION: 1) Majority of causes of deranged liver function tests during 3rd trimester were pregnancy induced. 2) Maternal and fetal outcome depends on gestational age of presentation, early recognition of the disease and tertiary care support.