Maternal and fetal outcome among pregnant women with jaundice and deranged LFTs attending a tertiary care institute: a prospective study

Ajay Sharma, Reena Sharma, Shuchi Sharma, N. Chauhan, Donka Bhargavi, Sumeet Verma, Divyani Totade
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Abstract

Background: This was a prospective study to analyses the maternal and fetal outcome among pregnant women with jaundice and deranged LFTs in a tertiary care hospital. Methods: This was a prospective observational study conducted in the department of Obstetrics and Gynaecology at SLBSGMC Nerchowk for a period of 6 months. The pregnant women with jaundice and deranged LFTs were included in the study after fulfilling inclusion and exclusion criteria. History, clinical examination and relevant investigations done. All patients followed till seven days in post-partum period. The maternal and fetal outcomes were noted.   Results: During study period we encountered 59 pregnant women with deranged LFTs. Majority of women were in primigravida (74.6%) in 20-30 years (55.9%) of age group. Most common symptom was pruritus in 59.3% of women. ICP was the most common cause amongst 64.4% of women. 40.7% 0f women had FTVD and 40.6% had cesarean delivery. AFD with MSL (87.5%) being the most common indication for cesarean delivery amongst these women. A total of 49 (83.1%) of newborn were delivered alive with good Apgar score, 1 (1.7%) was premature, 1 (1.7%) had respiratory distress syndrome (RDS). Conclusions: In contrary to older Indian studies our study concluded that though liver disease is less common, but on evaluation we found that intra-hepatic cholestasis being the number one cause of deranged LFTs in pregnancy in our hospital. Amongst these patients with high index of suspicion, prompt investigations, early diagnosis and timely management can improve the maternal and perinatal outcome.
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在三级医疗机构就诊的黄疸和精神错乱LFTs孕妇的母胎结局:一项前瞻性研究
背景:这是一项前瞻性研究,分析三级医院黄疸和精神错乱LFTs孕妇的母胎结局。方法:这是一项前瞻性观察研究,在SLBSGMC Nerchowk的妇产科进行,为期6个月。在满足纳入和排除标准后,将伴有黄疸和肝功能紊乱的孕妇纳入研究。病史、临床检查及相关调查。所有患者随访至产后7天。记录了产妇和胎儿的结局。结果:在研究期间,我们共遇到59例LFTs紊乱的孕妇。20 ~ 30岁年龄组(55.9%)女性以初迁期为主(74.6%)。59.3%的女性最常见的症状是瘙痒。ICP是最常见的病因,占64.4%。40.7%的女性有FTVD, 40.6%的女性有剖宫产。AFD合并MSL(87.5%)是这些妇女中最常见的剖宫产指征。新生儿存活49例(83.1%),Apgar评分良好,早产1例(1.7%),呼吸窘迫综合征(RDS) 1例(1.7%)。结论:与印度以前的研究相反,我们的研究得出结论,虽然肝脏疾病不太常见,但通过评估,我们发现肝内胆汁淤积是我院妊娠期肝功能紊乱的首要原因。在这些高怀疑指数的患者中,及时调查、早期诊断和及时处理可以改善孕产妇和围产儿的预后。
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