Abnormal Liver Function Test in Pregnant Females attending a Tertiary Care Hospital in Lahore

Salman  Javed; Najam Us Sher; Muhammad Qasim  Zia; Abid  Ali; Muhammad Haseeb  Nawaz; Muhammad  Adil

doi:10.29054/apmc/2022.1259

Salman Javed Assistant Professor, Department of Gastroenterology, SIMS/Services Hospital, Lahore Pakistan
Najam Us Sher Assistant Professor, Department of Gastroenterology, Gujranwala Medical College, Gujranwala Pakistan
Muhammad Qasim Zia Assistant Professor, Department of Gastroenterology, Khawaja Muhammad Safdar Medical College, Sialkot Pakistan
Abid Ali Senior Registrar, Department of Gastroenterology and Hepatology, Services Hospital, Lahore Pakistan
Muhammad Haseeb Nawaz Senior Registrar, Department of Gastroenterology and Hepatology, Services Hospital, Lahore Pakistan
Muhammad Adil Medical Officer, DHQ Teaching Hospital, Gujranwala Pakistan

DOI: https://doi.org/10.29054/apmc/2022.1259

Keywords: Abnormal liver function test, Preeclampsia, Fatty liver disease

Abstract

Background: To avoid diagnostic blunder, abnormal liver function tests (LFTs) related to pregnancy must be carefully evaluated. The underlying condition may have a significant impact on the results for both the mother and the foetus. Objective: Examining the clinical traits, frequency, and potential causes of anomalies in liver function tests was the aim of the current study. Study Design: Cross-sectional study. Settings: Obstetrics and Gynecology Department, in collaboration of Department of Gastroenterology, Services hospital, Lahore Pakistan. Duration: Six months from July to December 2020. Methods: 85 pregnant females with abnormal liver function tests. Drug induced abnormal liver function tests and women with chronic liver disease were excluded. Results: Total 85 patients were included. The incidence of abnormal LFT was 0.98%. The mean age was 33.40 ± 12.3. Most of the females 46 (54.1%) were young with age less than 30 years. Oedema 21 (24.7%) was the most common presenting complain. Liver disorder in this study was found in 15 (17.64%) women which was not specific to pregnancy & consisted of infective hepatitis, sickle cell disease & malaria whereas 70 (82.3%) women had1pregnancy-specific liver dysfunction. Four cases of diffuse intravascular coagulopathy were complex, and two of them were treated by transfusing blood components; the other two succumbed to AFLP and placental abruption, respectively. There were a total of seven maternal fatalities in the study. The remaining two, one with hepatitis E and the other with HELLP syndrome, both passed away from multi-organ failure. There were 34 (38.8%) females with intrauterine death inclusive of three cases of 2^nd trimester with early onset1pre-eclampsia. Number of preterm births was 8 that accounted for 9.41% of total 52 live births, 21 (24.7%) had intrauterine growth retardation and 23 (27%) were neonatal admissions. Conclusion: The most common reason for abnormal liver function tests during pregnancy, particularly in the third trimester, is pregnancy-specific diseases. The pre-eclampsia-related condition is the most prevalent of these diseases. If there is unawareness, abnormal LFT may go undetected, especially if jaundice is not the presenting symptom.