Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
The Journal of Obstetrics and Gynecology of India
Published in: The Journal of Obstetrics and Gynecology of India 1/2016

01-10-2016 | Original Article

Study of Abnormal Liver Function Test during Pregnancy in a Tertiary Care Hospital in Chhattisgarh

Authors: Nalini Mishra, V. N. Mishra, Parineeta Thakur

Published in: The Journal of Obstetrics and Gynecology of India | Special Issue 1/2016

Login to get access

Abstract

Introduction

Abnormal liver function tests (LFTs) in pregnancy require proper interpretation in order to avoid pitfalls in the diagnosis. The underlying disorder can have a significant effect on the outcome of both mother and foetus. The present study was done with the objective to study the clinical profile, incidence and possible causes of derangements of liver function tests.

Material and Method

Eighty pregnant women with abnormal liver dysfunction were studied prospectively. Women with chronic liver disease and drug-induced abnormal liver function test were excluded. All available LFTs including LDH were studied along with some more definitive tests to aid identification of underlying cause. Foetomaternal outcome was noted in all.

Result

The incidence of abnormal LFT was 0.9 %. 13/80 (16.75 %) women had liver disorder not specific to pregnancy, whereas 67/80 (83.25 %) women had pregnancy-specific liver dysfunction. Of these, 65(81.25 %) women with liver dysfunction had pre-eclampsia including 11 (13.75 %) with HELLP and six women with eclampsia. 48/65 (60 %) women had pre-eclampsia in the absence of HELLP syndrome or eclampsia. The mean value for bilirubin (mg %) in hypertensive disorders of pregnancy ranged from 1.64 to 3.8, between 5 and 10 for ICP and AFLP and >10 in infective hepatitis. Transaminases were highest in infective hepatitis, whereas alkaline phosphate was highest in ICP. Total 27 (33.75 %) women suffered from adverse outcome with four (5 %) maternal deaths and 23 (28.75 %) major maternal morbidities. 33/80 (41.25 %) women had intrauterine death. 26.25 % babies were small for date.

Conclusion

Pregnancy-specific disorders are the leading cause of abnormal liver function test during pregnant state particularly in the third trimester. Pre-eclampsia-related disorder is the commonest. Gestational age of pregnancy and relative values of various liver function tests in different pregnancy-specific and pregnancy nonspecific disorders appear to be the best guide to clinch the diagnosis.
Literature
1.
2.
Mitra AK, Patki PS, Mitra SK. Liver disorder during pregnancy and their management. Antiseptic. 2008;105(4):193–6.
3.
Cholongitas E, Burrough AK. Liver diseases specific to pregnancy. Ann Gastroenterol. 2008;21(3):164–72.
4.
Rathi U, Bapat M, Rathi P, et al. Effect of liver disease on maternal and fetal outcome—a prospective study. Indian J Gastroenterol. 2007;26:59–63.PubMed
5.
6.
Ching LY, Barge N, Dalal AR. Study of jaundice in pregnancy in a tertiary care Institute in India. Bombay Hosp J. 2011;53(2):181–3.
7.
Nagaria T, Agarwal S. Fetomaternal outcome in jaundice during pregnancy. J Obstet Gynecol India. 2005;55(5):424–7.
8.
Shukla S. A prospective study on acute viral hepatitis in pregnancy; seroprevalence, and fetomaternal outcome of 100 cases. J Biosci Tech. 2011;2(3):279–86.
9.
Gupta A, Kakkar T, Gupta Y, et al. Cholestasis of pregnancy. J Obstet Gynecol India. 2009;59(4):320–3.
10.
Wong HY, Tan JYL, Lim CC. Abnormal liver function tests in the symptomatic pregnant patient: the local experience in Singapore. Ann Acad Med Singapore. 2004;33:204–8.PubMed
11.
Tank PD, Nandanwar YS, Mayadeo NM. Outcome of pregnancy with severe liver disease. Int J Gynecol Obstet. 2002;76:27–31.CrossRef
12.
Harish K, Nitha R, Harikumar R, et al. Prospective evaluation of abnormal liver function tests in pregnancy. Trop Gastroenterol. 2005;26:188–93.PubMed
13.
Beniwal M, Kumar A, Kar P, et al. Prevalence and severity of acute viral hepatitis and fulminant hepatitis during pregnancy: a prospective study from north India. Indian J Med Microbiol. 2003;21:184–5.PubMed
14.
Dang A, Agarwal N, Bathla S, et al. Prevalence of liver disease in pregnancy and its outcome with emphasis on obstetric cholestasis: a Indian scenario. J Obstet Gynecol India. 2010;60(6):413–8.CrossRef
15.
Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103(5 Pt 1):981–91.CrossRefPubMed
16.
Pratt DS, Kaplan MM. Evaluation of abnormal liver enzyme results in asymptomatic patients. N Engl J Med. 2000;342:1266–71.CrossRefPubMed
17.
Sandhu BS, Sanyal AJ. Pregnancy and liver disease. Gastroenterol Clin N Am. 2003;32:407–36.CrossRef
18.
Loganathan G, Eapen CE, Chandy RG, et al. Acute fatty liver of pregnancy: a report of two cases. Natl Med J India. 2002;15:336–8.PubMed
19.
Krishna R, Valawan RT, Satyanarayan V, et al. Acute fatty liver of pregnancy—a case report. Trop Gastroenterol. 2003;24:135–6.PubMed
20.
Pokharel SM, Chattopadhyay SK, Jaiswal R, et al. HELLP syndrome—a pregnancy disorder with poor prognosis. Nepal Med Coll J. 2008;10(4):260–3.PubMed
21.
Jaiswal SP, Jain AK, Naik G, et al. Viral hepatitis during pregnancy. Int J Gynaecol Obstet. 2001;72:103–8.CrossRefPubMed
22.
Singh S, Mohanty A, Joshi YK, et al. Mother-to-child transmission of hepatitis E virus infection. Indian J Pediatr. 2003;70(1):37–9.CrossRefPubMed
23.
Veronica Irene Y, Kaur V. HEV infection in pregnancy. J Obstet Gynecol India. 2006;56(2):146–8.
Metadata
Title
Study of Abnormal Liver Function Test during Pregnancy in a Tertiary Care Hospital in Chhattisgarh
Authors
Nalini Mishra
V. N. Mishra
Parineeta Thakur
Publication date
01-10-2016
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue Special Issue 1/2016
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-015-0830-6

Other articles of this Special Issue 1/2016

The Journal of Obstetrics and Gynecology of India 1/2016 Go to the issue

Original Article

Correlation of Maternal Autoantibodies with Fetal Congenital Heart Block

Original Article

Homocysteine as Predictive Marker for Pregnancy-Induced Hypertension—A Comparative Study of Homocysteine Levels in Normal Versus Patients of PIH and Its Complications

Original Article

Reproductive Tract infections and Premalignant Lesions of Cervix: Evidence from Women Presenting at the Cancer Detection Centre of the Indian Cancer Society, Delhi, 2000–2012

Original Article

The Effectiveness of Levonorgestrel-Releasing Intrauterine System in the Treatment of Heavy Menstrual Bleeding

Original Article

Second Trimester Medical Termination of Pregnancy with Combined Intracervical and Intravaginal Misoprostol: Comparative Analysis with Intravaginal Misoprostol—A Pilot Study

Original Article

Trial of Labor After Cesarean Section Among Women with Unique Lower Segment Scarred Uterus and Fetal Weight >3500 g: Prognostic Factors for a Safe Vaginal Delivery