Effect of liver disease on maternal and fetal outcome--a prospective study.
BACKGROUND
Liver disease in pregnancy can have serious consequences. Its prevalence, profile and effect on outcome of pregnancy have not been documented systematically in India. We prospectively determined the frequency, causes and outcome of liver disease in pregnant women.


METHODS
Tertiary-care teaching hospital.


METHODS
Consecutive pregnant women with liver disease attending the inpatient or outpatient services of the Departments of Gastro-enterology and Obstetrics and Gynecology between December 2002 and October 2004 were evaluated and followed up till 2 weeks postpartum or death.


RESULTS
Liver disease was found in 107 (0.9%) of 12,061 pregnancies. Of these, fifty six (52.3%) had pregnancy-specific liver disorders (pregnancy-induced hypertension [PIH]-associated liver dysfunction 36--including HELLP syndrome 22 and pre-eclamptic liver dysfunction 14; intrahepatic cholestasis of pregnancy 10; hyperemesis gravidarum 7; acute fatty liver of pregnancy 3). Liver disorders not specific to pregnancy included hepatitis E (16), hepatitis B, non A-E hepatitis and chronic liver disease (5 each) and others (14); in 6 patients no cause could be found. Ninety-six patients completed follow up. Overall maternal and perinatal mortality rates were 19.7% and 35.4%, respectively.


CONCLUSIONS
PIH-associated liver dysfunction was the most common cause of liver disease in pregnancy. This is associated with significant maternal and perinatal morbidity and mortality.
Rathi
Umang
U
Department of Gastroenterology, Seth G S Medical College and King Edward Memorial Hospital, Mumbai 400 012, India.
Bapat
Mukta
M
Rathi
Pravin
P
Abraham
Philip
P
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007226:Infant Mortality; D007231:Infant, Newborn; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies