Liver Disease in Pregnancy: A Prospective Analysis of Maternal and Fetal Outcomes among 120 Patients at a Tertiary Care Center

Abstract

Background: Liver disorders during pregnancy pose unique challenges to the managing obstetrician in terms of consequences to the mother and the fetus. The aim of the study is to evaluate the various etiologies, clinical presentation, and to find out the maternal and fetal outcomes in mothers presenting with liver disorders during pregnancy. Methods: The study prospectively analyzed 120 consecutive patients who presented to our tertiary care center and were diagnosed to have some liver disease based on a combination of clinical, serological, or radiological evidence. Patients with liver disorder secondary to sepsis and multiorgan failure were excluded from the study. Results: A maximum number of patients were in the age group of 21-30 (73.3%). In terms of frequency, most common liver disorder was hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome (21.7%) cases followed by pre-eclampsia (19.2%) and Hepatitis E (14.2%). There was high presence of preterm deliveries comprising 64.25% of all deliveries. There were 107 live births and still birth was noted in 13 patients. Among the still birth group, the most common associated liver disease was Hepatitis E in 10 (76.9%) patients. The maternal mortality was 13.3% (16 patients). Hepatitis E was the single most important cause of mortality in all 16 patients. Conclusion: Pregnancy-specific liver disorders were far more common in the study and HELLP syndrome accounted for maximum number of cases. The presence of hepatitis E was the single most important cause of both fetal and maternal mortality.