Aarushi Chaudhary

Abstract

Introduction: Hypertensive disorders are common medical problems encountered during pregnancy with reported incidence between 5-10%. They form one of deadly triad along with haemorrhage and infection that contribute to maternal and fetal morbidity and mortality. Aim of the study was to evaluate demographic factors in preeclamptic patients with and without transaminitis and their impact on fetomaternal outcome. The objective of the study was to evaluate demographic factors in pregnant women with preeclampsia in singleton pregnancies with gestational age >24 weeks with and without transaminitis and their impact on fetomaternal outcome. Materials and Methods: Informed consent of patients was taken fulfilling the inclusion criteria. Demographic profile including age, socioeconomic status was noted. Detailed obstetric history was taken. Complete general, systemic and obstetric examination was done. Statistical Analysis: Using a prevalence rate of transaminitis of 24% amongst preeclamptic mothers based upon a previous study with an alpha error of 5% and a 5% margin of error the minimum required sample size was 281 patients. Discussion: Hypertensive disorders of pregnancy are one of the leading causes of maternal and perinatal morbidity and mortality. In Indian context, not many studies have been done to evaluate demographic factors influencing maternal and neonatal outcome amongst pregnant women with preeclampsia with and without deranged liver enzymes. Keywords: Fetomaternal outcome, Preeclampsia, Transaminitis.

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Abstract

Introduction: Hypertensive disorders during pregnancy may cause damage to liver which may manifest biochemically as a deranged liver function test and subsequent maternal morbidity and mortality any elevation in liver enzymes in a pre-eclamptic patient is significant and influences fetomaternal outcome this study evaluates the liver enzymes as a diagnostic and therapeutic tool in the management of preeclampsia and establishes a correlation between severity of liver function test derangement and severity of fetomaternal complications and use it as a predictive tool of severity of preeclampsia and for termination of pregnancy. Aim was to evaluate maternal and neonatal outcome in pre-eclamptic mothers with and without transaminitis. Primary objective of the study was to compare the maternal and neonatal outcome in pregnant women with preeclampsia in singleton pregnancies with gestational age >24 weeks with and without transaminitis. Secondary objective was to correlate the severity of liver enzyme derangement in preeclamptic mothers with adverse maternal and / or fetal outcome and use it as a predictive tool of severity of preeclampsia and for termination of pregnancy Materials and Methods: This prospective cohort study was conducted on 281 patients after approval by the institute ethics committee informed consents were taken from patients inclusion and exclusion criteria were met all enrolled patients were classified into mild, moderate and severe hypertension and managed as per standard guidelines. Specific investigations were performed if during any visit ast >25 iu/l and/or alt >32iu/l and/or alp > 418 iu/l, patients were called again after a week and blood pressure and fetomaternal well-being was assessed termination of pregnancy was done as per standard guideline statistical analysis done and hypothesis established. Results: From the present study it can be derived that at ast >66 iu/l and alt > 64 iu/l poor maternal outcome is expected with ast >60 iu/l and alt>64 iu/l adverse fetal complications are likely to occur. Conclusion: From the present study it can be concluded that severity of liver function test derangement is directly related to severity of preeclampsia which in turn is related to severity of fetomaternal complications. Keywords: Elevated liver enzymes, Preeclampsia, Maternal, Neonatal outcome.

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