Pregnancy Outcomes in Pre-eclampsia with Impaired Liver Function with Anesthesia outcome

Background: Pre-eclampsia is a severe pregnancy complication marked by hypertension and proteinuria, often complicated by impaired liver function, leading to increased maternal and fetal morbidity and mortality. In resource-limited settings like Bangladesh, the burden of pre-eclampsia is high, compounded by inadequate healthcare access and delayed diagnosis. Liver dysfunction in pre-eclampsia, associated with conditions like HELLP syndrome, requires careful anesthetic management to mitigate risks for both mother and fetus. Objective: This study aims to assess pregnancy outcomes and anesthetic challenges associated with pre-eclampsia complicated by liver dysfunction in a tertiary care hospital in Bangladesh. Method: A prospective observational study was conducted from January 2023 to December 2023, involving 60 patients diagnosed with severe pre-eclampsia. Patients were categorized based on anesthetic management into two groups: 40 receiving spinal anesthesia and 20 undergoing general anesthesia. Pregnancy outcomes and anesthesia-related complications were analyzed, with biochemical markers (bilirubin, SGPT, LDH, platelet count, fibrinogen) used to assess liver dysfunction. Statistical analysis was performed using Chi-square tests, with a significance level of p<0.05. Results: The study revealed that the majority of patients were in the 22-29 years age group (63%). Common complaints included headache and epigastric pain, while biochemical markers indicated significant liver dysfunction, particularly elevated bilirubin, SGPT, and LDH levels. Pregnancy outcomes showed that 65% of cases had no complications, 20% had fetal complications, and 10% experienced maternal complications. Elevated serum uric acid levels (>6mg%) were significantly associated with fetal affection (p=0.02). Regarding anesthesia outcomes, spinal anesthesia showed fewer complications (hypotension 5%, nausea 3%) compared to general anesthesia, which had higher rates of airway complications (10%) ...