title: Study of Abnormal Liver Function Test during Pregnancy in a Tertiary Care Hospital in Chhattisgarh.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynaecology, Pt. J N M Medical College & BRAM Hospital Raipur (C.G.), 27/272 New Shantinagar, Raipur, C.G. 492001 India.
authors.forename: Nalini
authors.initials: N
authors.lastname: Mishra
authors.affiliation: Department of Medicine, Pt. J N M Medical College & BRAM Hospital Raipur (C.G.), Raipur, India.
authors.forename: V N
authors.initials: VN
authors.lastname: Mishra
authors.affiliation: Department of Obstetrics and Gynaecology, Pt. J N M Medical College & BRAM Hospital Raipur (C.G.), Raipur, India.
authors.forename: Parineeta
authors.initials: P
authors.lastname: Thakur
keywords: Abnormal liver function test in pregnancy; Acute fatty liver of pregnancy; HELLP syndrome; Pre-eclampsia