Outcomes of liver diseases in pregnant females: A study from a tertiary care medical center in Pakistan

Nazish Butt; Sabir  Ali; Haleema  Yasmeen; Khalid  Mumtaz

doi:10.12669/pjms.40.3.7670

Nazish Butt Gastroenterology Department, Jinnah Post graduate Medical Centre, Karachi, Pakistan.
Sabir Ali Gastroenterology Department, Jinnah Post graduate Medical Centre, Karachi, Pakistan.
Haleema Yasmeen Gastroenterology Department, Jinnah Post graduate Medical Centre, Karachi, Pakistan.
Khalid Mumtaz The Ohio State University, Columbus, United States. Division of Gastroenterology, Hepatology & Nutrition

DOI: https://doi.org/10.12669/pjms.40.3.7670

Keywords: Liver Diseases, Pregnancy, Etiology, HEV, HELLP, Fulminant Hepatic Failure, Maternal Complications, Fetal Complications, Maternal Mortality, Fetal Mortality

Abstract

Objective: To determine the etiologies and outcomes of liver disease in pregnancy in a developing country.

Method: A total of 336 consecutive pregnant women with liver disease were included in this prospective cohort study conducted at the Department of Gastroenterology, Jinnah Postgraduate Medical Center, Karachi from August 2019 to August 2021. Patients’ baseline demographic, clinical, and laboratory data and outcomes were collected on a pre-designed questionnaire.

Results: Among all the pregnant females, the most common liver disease was acute hepatitis E virus (HEV) infection (37.2%), followed by preeclampsia (PEC)/eclampsia (EC), hemolysis, elevated liver enzymes & low platelets (HELLP) syndrome, and hyperemesis gravidarum (HG). The most common maternal complications were fulminant hepatic failure (FHF) in 14.9% and placental abruption in 11.0%. Fetal complications included intrauterine death (IUD) in 20.8% and preterm birth in 8.6%. The maternal and neonatal mortality rates were 11.6% and 39.6%, respectively. Among the predictors, low maternal weight, low body mass index (BMI), and low hemoglobin (Hb) were associated with increased maternal mortality. Low fetal weight, height, maternal systolic blood pressure (SBP), and low maternal Hb were independent predictors of fetal mortality.

Conclusion: In our cohort of pregnant females in a tertiary care medical center, acute HEV was the most common liver disease, followed by PEC/EC, HELLP, and HG. Maternal and fetal deaths were alarming in this group of patients and demanded careful management.

doi: https://doi.org/10.12669/pjms.40.3.7670

How to cite this: Butt N, Ali S, Yasmeen H, Mumtaz K. Outcomes of liver diseases in pregnant females: A study from a tertiary care medical center in Pakistan. Pak J Med Sci. 2024;40(3):284-290. doi: https://doi.org/10.12669/pjms.40.3.7670

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.