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Abstract：
BACKGROUND: Pregnant women with abnormal liver function tests (LFTs) require proper evaluation and timely management to reduce maternal and fetal morbidity and mortality.
OBJECTIVE: The present study was done with the objective of determining feto-maternal outcomes in antenatal women with abnormal LFTs and comparing them with antenatal women having normal liver function. The prevalence and possible causes of derangements in LFT were also identified.
METHODS: Pregnant women referred to an antenatal clinic for several reasons pertaining to abnormal liver functions, and those admitted to the labor room for delivery with abnormal LFTs were included in the study. The pregnant women with abnormal LFT were studied prospectively, and they were compared with pregnant women having normal LFT. The fetal and maternal outcomes were also noted.
RESULTS: The pregnant women attending the antenatal clinic with a history of pruritus, abdominal pain, jaundice, nausea/vomiting, hypertension ascites, etc. and delivered at our facility were evaluated. One hundred and eight women had abnormal LFT defined by criteria laid down in material and methods. Eighty-seven women with normal LFT were taken for comparison. In the abnormal LFT, the main cause was intrahepatic cholestasis of pregnancy (IHCP). There were 6 (5.5%) maternal deaths in this group and none in the normal LFTs. There were 6 (5.6%) fetal deaths and 4 (4.6%) in the other group (p-value=1). The prevalence of abnormal LFT was 9.11% throughout pregnancy. Increased bilirubin and alkaline phosphatase (ALP) were significantly correlated with maternal mortality, while gestational age at birth, presence of meconium, appearance, pulse, grimace, activity, and respiration (APGAR) score, maternal mortality, and raised alkaline phosphatase level were found to be significantly associated with fetal mortality.
CONCLUSIONS: Patients with abnormal LFT were significantly associated with maternal morbidity and mortality. However, fetal outcomes in patients with abnormal and normal LFT were similar. Hyperbilirubinemia and raised alanine aminotransferase (ALT) were significant predictors of maternal mortality.
OBJECTIVE: The present study was done with the objective of determining feto-maternal outcomes in antenatal women with abnormal LFTs and comparing them with antenatal women having normal liver function. The prevalence and possible causes of derangements in LFT were also identified.
METHODS: Pregnant women referred to an antenatal clinic for several reasons pertaining to abnormal liver functions, and those admitted to the labor room for delivery with abnormal LFTs were included in the study. The pregnant women with abnormal LFT were studied prospectively, and they were compared with pregnant women having normal LFT. The fetal and maternal outcomes were also noted.
RESULTS: The pregnant women attending the antenatal clinic with a history of pruritus, abdominal pain, jaundice, nausea/vomiting, hypertension ascites, etc. and delivered at our facility were evaluated. One hundred and eight women had abnormal LFT defined by criteria laid down in material and methods. Eighty-seven women with normal LFT were taken for comparison. In the abnormal LFT, the main cause was intrahepatic cholestasis of pregnancy (IHCP). There were 6 (5.5%) maternal deaths in this group and none in the normal LFTs. There were 6 (5.6%) fetal deaths and 4 (4.6%) in the other group (p-value=1). The prevalence of abnormal LFT was 9.11% throughout pregnancy. Increased bilirubin and alkaline phosphatase (ALP) were significantly correlated with maternal mortality, while gestational age at birth, presence of meconium, appearance, pulse, grimace, activity, and respiration (APGAR) score, maternal mortality, and raised alkaline phosphatase level were found to be significantly associated with fetal mortality.
CONCLUSIONS: Patients with abnormal LFT were significantly associated with maternal morbidity and mortality. However, fetal outcomes in patients with abnormal and normal LFT were similar. Hyperbilirubinemia and raised alanine aminotransferase (ALT) were significant predictors of maternal mortality.
摘要：
背景：肝功能检查（LFTs）异常的孕妇需要适当的评估和及时的管理，以降低孕产妇和胎儿的发病率和死亡率。
目的：本研究的目的是确定LFT异常的产前妇女的胎儿-母体结局，并将其与肝功能正常的产前妇女进行比较。还确定了LFT紊乱的患病率和可能原因。
方法：孕妇因肝功能异常而转诊到产前诊所，那些因LFTs异常而入院分娩的人也被纳入研究。对LFT异常的孕妇进行了前瞻性研究，并将其与LFT正常的孕妇进行比较。还注意到胎儿和母亲的结局。
结果：在产前门诊就诊并有瘙痒病史的孕妇，腹痛,黄疸,恶心/呕吐，高血压腹水，等。并在我们的设施交付进行了评估。根据材料和方法中规定的标准，有108名妇女患有异常的LFT。选取87名LFT正常的女性进行比较。在异常LFT中，主要病因为妊娠期肝内胆汁淤积症(IHCP).该组中有6例（5.5％）孕产妇死亡，而正常的LFT则没有。另一组有6例（5.6％）胎儿死亡和4例（4.6％）胎儿死亡（p值=1）。整个孕期LFT异常的患病率为9.11%。胆红素和碱性磷酸酶(ALP)升高与孕产妇死亡率显著相关,而出生时的胎龄，胎粪的存在，外观,脉搏,鬼脸,活动,和呼吸（APGAR）评分，孕产妇死亡率,发现碱性磷酸酶水平升高与胎儿死亡率显著相关。
结论：LFT异常患者与产妇发病率和死亡率显著相关。然而,LFT异常和正常患者的胎儿结局相似.高胆红素血症和丙氨酸转氨酶（ALT）升高是孕产妇死亡率的重要预测因素。
目的：本研究的目的是确定LFT异常的产前妇女的胎儿-母体结局，并将其与肝功能正常的产前妇女进行比较。还确定了LFT紊乱的患病率和可能原因。
方法：孕妇因肝功能异常而转诊到产前诊所，那些因LFTs异常而入院分娩的人也被纳入研究。对LFT异常的孕妇进行了前瞻性研究，并将其与LFT正常的孕妇进行比较。还注意到胎儿和母亲的结局。
结果：在产前门诊就诊并有瘙痒病史的孕妇，腹痛,黄疸,恶心/呕吐，高血压腹水，等。并在我们的设施交付进行了评估。根据材料和方法中规定的标准，有108名妇女患有异常的LFT。选取87名LFT正常的女性进行比较。在异常LFT中，主要病因为妊娠期肝内胆汁淤积症(IHCP).该组中有6例（5.5％）孕产妇死亡，而正常的LFT则没有。另一组有6例（5.6％）胎儿死亡和4例（4.6％）胎儿死亡（p值=1）。整个孕期LFT异常的患病率为9.11%。胆红素和碱性磷酸酶(ALP)升高与孕产妇死亡率显著相关,而出生时的胎龄，胎粪的存在，外观,脉搏,鬼脸,活动,和呼吸（APGAR）评分，孕产妇死亡率,发现碱性磷酸酶水平升高与胎儿死亡率显著相关。
结论：LFT异常患者与产妇发病率和死亡率显著相关。然而,LFT异常和正常患者的胎儿结局相似.高胆红素血症和丙氨酸转氨酶（ALT）升高是孕产妇死亡率的重要预测因素。
