Predictors of Feto-Maternal Outcome in Pregnancies Complicated by Hepatic Dysfunction: Observational Study in a Tertiary Care Hospital in Punjab
Journal Title: Pan Asian Journal of Obstetrics & Gynecology - Year 2019, Vol 2, Issue 1
Abstract
Introduction: The spectrum of hepatic dysfunction complicating pregnancy has varied underlying etiologies and is associated with grave feto-maternal prognosis. There is an imperative need to identify individuals at risk and recognize factors predicting poor outcome in order to improve maternal survival. There is paucity of literature published about predictors of survival and utility of low cost, easily available biochemical and hematological investigations as reliable tools for feto-maternal prognostication. Aim: The present study aims to analyze maternal and fetal outcome in pregnancies complicated by hepatic dysfunction and to evaluate various clinico-demographic, biochemical and hematological variables as reliable tools for predicting feto-maternal outcome in such pregnancies. Materials and methods: It was a prospective observational study in 118 antenatal women with hepatic dysfunction in pregnancy. Clinico-demographic, biochemical and hematological variables were analyzed. Common laboratory parameters across underlying etiologies of hepatic dysfunction were compared using appropriate statistical methods and their predictive performance as feto-maternal adverse outcome predictors was analyzed. Results: Pre-eclampsia (42.4%) was the most common underlying etiology of hepatic dysfunction. Maternal mortality rate was 5.9%. Neonatal intensive care was required in 27.6% babies. Presence of coagulopathy, elevated serum bilirubin levels and thrombocytopenia were associated with grave feto-maternal prognosis. Conclusion: Total serum bilirubin and international normalized ratio are important predictors of feto-maternal outcome.
Authors and Affiliations
Shivali Bhalla, Seema Grover Bhatti, Sumit Kumar, Prabhleen Kaur
Keywords
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