STUDY OF LIVER FUNCTION PARAMETERS IN PREGNANT WOMEN ATTENDING A TERTIARY CARE CENTRE

Abstract

Introduction: Changes in liver biochemical prole are normal during pregnancy. However, severe liver disease, although rare, can occur and must be recognized at an early stage to reduce morbidity and mortality for mother and infant.The pathological derangement in the liver functions may be related to pregnancy or may coexist with pregnancy and may be divided into three major groups. We aim to nd the incidence and possible (pregnancy-specic liver disorder and pregnancy non-specic liver disorder) of alteration in liver function tests (LFTs) in pregnant women attending tertiary care center. Aim and Objectives: To determine the association between altered Liver function tests and Possible causes of liver disorders in Pregnancy. Materials and Methods: Sampling data was collected over a period time of 1 Year. The study was done at the Clinical Biochemistry Department, tertiary care rural center. All data will be collected from the solace-laboratory Information system of the clinical biochemistry register at the central diagnostic laboratory. The sample size of the study is 83. Then, we plot the data according to the incidence of variable causes of liver disorderspecic and non-specic to pregnancy, also calculate the degree of alteration in LFTs in particular causes. Result: This study included a total of 83 individual cases (females only-age 18 to 35 years). 41 (49%) out of 83cases were related to pre-eclampsia, 12 (14%) cases related to HELLP syndrome, 2 (2%) cases related to AFLP, 3 (4%) cases related to ICP, 7 (8%) cases related to viral hepatitis, 3 (4%) cases related to Hyperemesis, 8 (10%) cases related to Eclampsia & 7 (8%) cases related to Miscellaneous. ALP level increase in viral hepatitis (mean 585.4 u/l, SD± 68.5), pre-eclampsia (mean 239.28 U/L, SD ± 38.25) and decrease level in miscellaneous Causes (mean 82.2 u/l, SD± 37.4) & ICP (mean 103.3 u/l ,SD±30.0). The AST level was rise in viral hepatitis (mean 781.8 µ/l, SD ± 46.14), AFLP (mean 708.5 u/l, SD ± 12.0), ICP (mean 100 u/l, SD ± 4.35), preeclampsia (mean 123.3 u/l, SD ± 22.0) and remain normal in miscellaneous cause (mean 21.2 u/l, SD ± 8.22) & hyper emesis (mean 25.66 u/l, SD ± 4.50). Conclusion: Alterations in Liver function test results were due to Liver disease in pregnancy include -a 3-to-4-fold rise in the level of alkaline phosphatase (ALP) in viral hepatitis, Pre-eclampsia & AFLP. An increase in the total bilirubin level was found in viral hepatitis, pre-eclampsia & HELLP syndrome, whereas a downward trend was seen in the levels of serum albumin and total proteins. Serum ALT & AST levels become a rise in Pre-eclampsia, Viral hepatitis, Eclampsia, and also AFLP. It was found that serum AST level was in normal limits in hyperemesis &miscellaneous.