Study of Liver Diseases in Pregnancy and Their Implications for Maternal and Fetal Outcomes

Background During pregnancy, liver disease (LD) is associated with grave consequences, for both mother and fetus, and can be a challenge for health care providers. The objective of this study is to evaluate the prevalence, the difference between common causes of pregnancy-related LD and the post-pregnancy outcomes. Methods The study was conducted at a tertiary care teaching hospital over 19 months. Pregnant women attending antenatal clinic with pre-existing LD or those suspected to have LD on the basis of clinical or investigation data were studied and followed up till delivery. Management was based on obstetric assessment of fetus and its well-being, cervical favorability and fetal size in combination with liver function tests. Results Around 126 (3.2%) of the pregnant women in the study had LD. Among them, 85 (74.5%) of the affected patients had pregnancy-specific LD and 25 (21.9%) had viral hepatitis. Out of the total 114 participants, 77 were nulliparous (67.5%) and 37 (32.5%) were multiparous. A majority (91, 79.8%) presented at >28 weeks of gestation. Intrahepatic cholestasis of pregnancy was the commonest (63, 55.3%) LD affecting pregnancy, followed by pre-eclampsia and chronic hepatitis B virus (HBV) infection 14 (12.3% each) pregnant women. There were two (1.75%) maternal deaths and five (4.2%) intrauterine deaths. Conclusion In pregnancies with liver disorders, the outcomes for both the mother and the fetus may be improved by early diagnosis, suitable supportive care, and a proactive policy of early delivery when indicated.