A PROSPECTIVE STUDY ON PREGNANCY COMPLICATED WITH JAUNDICE AND FETOMATERNAL OUTCOME
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i9.45280Keywords:
Alanine transaminase, Alkaline phosphatase, Bilirubin, Liver diseases, Low birth weight, ThrombocytopeniaAbstract
Objectives: The aim of the study was to determine biochemical factors and maternofetal outcome in women with jaundice during pregnancy and to study its association with jaundice in pregnancy.
Methods: It was an observational study done among 60 pregnant patients with abnormal liver functioning. Laboratory parameters were studied which mainly includes liver function tests. Demographics and the detailed clinical history were recorded. The detailed laboratory investigation was carried out to study the complications concerning biochemical parameter. SPSS (Version 22.0) was used for analysis.
Results: HELLP syndrome was the most common etiology (45%). Decreased levels of hemoglobin observed in 75%, increased total leukocyte count observed in 26%, and low platelet count observed in 34%, respectively. Among mothers, most common adverse outcome was requirement of emergency lower segment cesarean section (45%). Maternal outcomes were significantly associated with raised direct bilirubin, raised serum glutamic pyruvic transaminase, raised alkaline phosphatase, and thrombocytopenia (p=0.03, p=0.01, p=0.02, and p=0.01, respectively).
Conclusion: Hepatic dysfunction during pregnancy is associated with adverse events for both the mother and the fetus.
Downloads
References
Suresh I, Vijaykumar TR, Nandeesh HP. Predictors of fetal and maternal outcome in the crucible of hepatic dysfunction during pregnancy. Gastroenterol Res 2017;10:21-7.
International Classification of Diseases. 10th Revision, Clinical Modification (ICD-10-CM). Available from: https://www.cdc.gov/ nchs/icd/icd10cm.htm [Last assessed on 2021 Jan 28].
Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Rouse DW, Spong CY. Hepatic, Gallbladder, and Pancreatic Disorders. In: Williams Obstetrics. 3rd ed. New York: McGraw-Hill; 2010.
Choudhary N, Sen S, Varalakshmi K. A prospective study on pregnancy complicated with jaundice with special emphasis on fetomaternal outcome. Int J Reprod Contracept Obstet Gynecol 2017;6:5081-88. doi: 10.18203/2320-1770.ijrcog20175029.
Sharma AV, John S. Liver Disease in Pregnancy. In: Stat Pearls Florida: Stat Pearls; 2019. Available from: https://www.ncbi.nlm.nih. gov/ books/NBK482201 [Last accessed on 2019 Jul 30].
Reddy MG, Prabhakar GC, Sree V. Maternal and fetal outcome in jaundice complicating pregnancy. J NTR Univ Health Sci 2014;3:231- 33. doi: 10.4103/2277-8632.146598.
Allen AM, Kim WR, Larson JJ, Rosedahl JK, Yawn BP, McKeon K, et al. The epidemiology of liver diseases unique to pregnancy in a US community: A population-based study. Clin Gastroenterol Hepatol 2016;14:287-94.e1. doi: 10.1016/j.cgh.2015.08.022, PMID 26305066.
Satia MN, Jandhyala MA. Study of fetomaternal outcomes in cases of jaundice at a tertiary care center. Int J Reprod Contracept Obstet Gynecol 2016;5:2352-57.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427-51.
Stephen G, Mgongo M, Hussein Hashim T, Katanga J, Stray-Pedersen B, Msuya SE. Anaemia in pregnancy: Prevalence, risk factors, and adverse perinatal outcomes in Northern Tanzania. Anemia 2018;2018:1846280. Article ID 1846280. doi: 10.1155/2018/1846280, PMID 29854446.
Bakrim S, Motiaa Y, Ouarour A, Masrar A. Hematological parameters of the blood count in a healthy population of pregnant women in the Northwest of Morocco (Tetouan-M’diq-Fnideq provinces). Pan Afr Med J 2018;29:205. doi: 10.11604/pamj.2018.29.205.13043, PMID 30100959.
Lata I. Hepatobiliary diseases during pregnancy and their management: An Update. Int J Crit Illn Inj Sci 2013;3:175-82. doi: 10.4103/2229- 5151.119196, PMID 24404454.
Roncaglia N, Trio D, Roffi L, Ciarla I, Tampieri A, Scian A, et al. Intrahepatic cholestasis in pregnancy: Incidence, clinical course, complications. Ann Ostet Ginecol Med Perinat 1991;112:146-51. PMID 1812797.
Shinde NR, Patil TB, Deshpande AS, Gulhane RV, Patil MB, Bansod YV. Clinical profile, maternal and fetal outcomes of acute hepatitis E in pregnancy. Ann Med Health Sci Res 2014;4(Suppl 2):S133-9. doi: 10.4103/2141-9248.138033, PMID 25184080.
Parveen T, Begum F, Akhter N. Feto-maternal outcome of jaundice in pregnancy in a tertiary care hospital. Mymensingh Med J 2015;24:528- 36. PMID 26329951.
Stangret A, Wnuk A, Szewczyk G, Pyzlak M, Szukiewicz D. Maternal hemoglobin concentration and hematocrit values may affect fetus development byinfluencing placental angiogenesis. J Matern Fetal Neonatal Med 2017;30:199-204. doi: 10.3109/14767058.2016.1168395, PMID 27076257.
Bora R, Sable C, Wolfson J, Boro K, Rao R. Prevalence of anemia in pregnant women and its effect on neonatal outcomes in Northeast India. J Matern Fetal Neonatal Med 2014;27:887-91. doi: 10.3109/14767058.2013.845161, PMID 24041147.
Published
How to Cite
Issue
Section
Copyright (c) 2022 Haridas Govinda Warrier
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.