Late gestational liver dysfunction and its impact on pregnancy outcomes

Area of Science:

• Obstetrics and Gynecology
• Hepatology
• Maternal-Fetal Medicine

Background:

• Liver dysfunction during late pregnancy poses risks to maternal and fetal health.
• Understanding the specific impacts of varying degrees of liver dysfunction is crucial for clinical management.

Purpose of the Study:

• To investigate the association between late gestational liver dysfunction and pregnancy outcomes.
• To analyze the impact of different transaminase levels on maternal and fetal health.

Main Methods:

• A comparative study involving pregnant women with liver dysfunction (observation group) and those with normal liver function (control group) from 2010-2012.
• Analysis of pregnancy outcomes, including cesarean section rates, postpartum hemorrhage, fetal distress, and specific liver conditions.

Main Results:

• Higher incidence of cesarean section, postpartum hemorrhage, fetal distress, premature birth, and premature rupture of membranes in the observation group, especially with severe transaminase elevation.
• Severe liver dysfunction was linked to increased rates of intrahepatic cholestasis of pregnancy (ICP), gestational hypertension with HELLP syndrome, and acute fatty liver in pregnancy (AFLP).
• Mildly elevated transaminases were primarily associated with non-alcoholic fatty liver disease (NAFLD) or unknown causes, while viral hepatitis and biliary tract diseases showed no significant difference across transaminase levels.

Conclusions:

• Late gestational liver dysfunction, particularly when severe, significantly increases the risk of adverse maternal events.
• Intrahepatic cholestasis of pregnancy (ICP), gestational hypertensive disorders, and acute fatty liver in pregnancy (AFLP) are the primary contributors to severe liver dysfunction in late pregnancy.