Goyal Mohan B, Kirnake Vijendra, Goyal Manisha, Shende Unnati
Gastroenterology and Hepatology, National Institute of Medical Science and Research (NIMS), Jaipur, IND.
Gastroenterology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND.
Cureus. 2025 Aug 17;17(8):e90310. doi: 10.7759/cureus.90310. eCollection 2025 Aug.
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.
背景 在孕期，肝脏疾病（LD）对母亲和胎儿均会造成严重后果，并且可能给医护人员带来挑战。本研究的目的是评估与妊娠相关的LD的患病率、常见病因之间的差异以及妊娠后的结局。方法 本研究在一家三级护理教学医院进行，为期19个月。对在产前门诊就诊的患有既往LD的孕妇或根据临床或检查数据怀疑患有LD的孕妇进行研究，并随访至分娩。管理措施基于对胎儿及其健康状况、宫颈成熟度和胎儿大小的产科评估，并结合肝功能检查结果。结果 本研究中约126名（3.2%）孕妇患有LD。其中，85名（74.5%）受影响患者患有妊娠特异性LD，25名（21.9%）患有病毒性肝炎。在总共114名参与者中，77名（67.5%）为初产妇，37名（32.5%）为经产妇。大多数（91名，79.8%）在妊娠>28周时就诊。妊娠期肝内胆汁淤积症是影响妊娠最常见的LD（63名，55.3%），其次是子痫前期和慢性乙型肝炎病毒（HBV）感染，各有14名（12.3%）孕妇。有2例（1.75%）孕产妇死亡和5例（4.2%）宫内死亡。结论 在患有肝脏疾病的妊娠中，通过早期诊断、适当的支持性护理以及在必要时采取积极的早期分娩政策，母亲和胎儿的结局可能会得到改善。
