Maternal and Fetal Outcome in Deranged Liver Function Test and Jaundice Complicating Pregnancy: A Prospective Study

Abstract

Background: The objective of the study was to study maternal and fetal outcome in pregnancy complicated with deranged liver function test and jaundice.

Methods: Total 150 antenatal patients with clinical or laboratory evidence of abnormal liver function test and jaundice were selected for study done for a period of one-and-half year at a tertiary care hospital in north India.

Results: All cases were in their third trimester of pregnancy out of which 93.3% were unbooked cases. Most of the patients presented with pregnancy induced hypertension, fever and jaundice at time of admission. Other presenting complaints were nausea, vomiting, pedal edema, abdominal pain and including 3 cases of altered sensorium. Acute viral hepatitis was most important cause of jaundice in this study followed by preeclampsia and ICP were other causes of jaundice in this study. Hepatitis B was the most common cause of acute hepatitis (26.7%) followed by hepatitis C (6.7%). Maternal mortality was seen in 4 cases (3 cases of Eclampsia & HELLP syndrome and one case of multi-organ failure). 138 patients were kept in ICU for intensive monitoring. Preterm delivery was most common maternal complication. Of all the deliveries, 26.7% were preterm, 31(21%) were IUFD, 57(38%) had fetal distress with meconium stained liquor, 27 (18%) had PROM, 50 (33%) had fetal growth restriction.

Conclusions: Deranged liver function and jaundice in pregnancy results in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and intensive care management.