PATTERN OF LIVER DYSFUNCTION AMONG ANTENATAL WOMEN ATTENDING OPD OF A TERTIARY CARE CENTER

Background: Liver disorders in pregnancy encompass a spectrum of diseases encountered during antenatal and postnatal period resulting in abnormal liver function tests and hepatobiliary dysfunction or both. This study is aimed at determining the pattern of liver disorders during pregnancy.

Methods:One hundred patients with liver disorders during pregnancy during the period of one year were included. Data was recorded in Excel workbook and analyzed.

Results:91% of the women had liver disorders peculiar to pregnancy while 7% of the women had liver diseases which were coincidental to pregnancy while 2 women had preexisting liver disease. Our study observed that 2 women had chronic hepatitis. Five percent of the women had hepatitis B and 2% had chronic hepatitis C infection. Forty percent of the women had preeclampsia, 26% had cholestasis, and 2% had acute liver failure. The most common antepartum complication was gestational hypertension and pre-eclampsia (34% followed by IUGR (17%).

Conclusions:Liver disease has deleterious effect on pregnancy outcome with increased maternal and foetal morbidity and mortality. Timely diagnosis by proper antenatal check-up, early interventions and intensive monitoring of both mother and fetus with the teamwork of obstetrician, physician, gastroenterologist, and anaesthetist can prevent and reduce feto-maternal morbidity and mortality.

背景：妊娠合并肝病涵盖产前与产后阶段出现的各类疾病，可导致肝功能指标异常、肝胆功能障碍，或二者兼具。本研究旨在明确妊娠期间肝病的发生类型与分布特征。
方法：本研究纳入了1年内确诊的100例妊娠合并肝病患者，相关数据通过Excel表格记录并开展分析。
结果：本研究中，91%的患者罹患妊娠特异性肝病，7%的患者为妊娠偶合性肝病，另有2例患者存在既往肝病病史。2例患者被诊断为慢性肝炎；5%的患者为乙型病毒性肝炎感染者，2%的患者为慢性丙型病毒性肝炎感染者。40%的患者合并子痫前期，26%的患者合并妊娠期肝内胆汁淤积症，2%的患者发生急性肝衰竭。最常见的产前并发症为妊娠期高血压与子痫前期（占比34%），其次为胎儿宫内生长受限（Intrauterine Growth Restriction，IUGR，占比17%）。
结论：肝病对妊娠结局存在不良影响，可升高孕产妇与胎儿的发病率及死亡率。通过规范产前检查实现及时诊断、早期干预，并由产科医师、内科医师、胃肠科医师与麻醉医师团队协作，对孕产妇及胎儿进行强化监测，可有效预防并降低母婴不良事件的发生率与死亡率。