Maternal and Perinatal Outcome of Liver Function in Severe Pre Eclampsia and Eclampsia Patients
Background: Preeclampsia and eclampsia are common pregnancy specific multi system disorder in Bangladesh and are major causes of maternal, foetal and neonatal mortality and morbidity. Objective: To determine the extent of hepatic involvement in severe preeclampsia & eclampsia and its relation to fetomaternal outcome. Methods: It was a hospital based prospective study. This randomized clinical trial was conducted to evaluate liver function in severe preeclampsia and eclampsia on 100 patients with severe preeclampsia and eclampsia selected randomly who were admitted in department of obstetrics and gynaecology unit of Rangpur medical college and hospital through outpatient department and emergency during a time period of June 2015 to November 2015. Data was collected in preformed questionnaires after taking written informed consent from the patient or legal guardian after proper counseling.Then date was presented in graph and tabulated form and finally analyzed by SPSS version–16. Results: 100 patients were taken in this study–62 as eclampsia and 38 as severe preeclampsia. 0ut of 100 patients maximum (60%) were between 20-35 years of age, 62% patients were primigravida, 46% were more than 36 weeks of gestation, 53% patients were belonged to low socioeconomic status, 59% patients were primarily educated, 25% patients had no antenatal checkup and 42% were on irregular antenatal checkup. Most of the severe preeclamptic patients presented on admission with headache (65.78%) and epigastric pain (13.15%) and most of the eclamptic patient (51.61%) were conscious and 29.03% were unconscious. Maximum patients (56%) were delivered by LSCS. In severe preeclampsia group blood urea were raised in 73.68%, S. Creatinine were raised in 71.05% and S.Uric acid were raised in 65.78%. Liver function was abnormal in 21.05% patients among them S.bilirubin was raised in 15.7%, SGPT was raised in 21.05% patients SGOT was raised in 18.42% patients. LDH was raised in 13.15% patients. In eclamptic patients’ blood urea was raised in 72.58% patients, S. creatinine was raised in 66.12% patients; S. uric acid was raised in 61.29% patients. Liver function was abnormal in 22.58% patients, among them, S. bilirubin was raised in 29.03%, SGPT in 48.38%, SGOT was raised in 30.64% and LDH was raised in 45.16% patients. Maternal morbidity and mortality was more in patients with abnormal liver function. It maternal mortality was 12.5% in severe preeclamptic patients and 14.28% in eclamptic patients with abnormal liver function. Perinatal morbidity and mortality was also higher in patients with abnormal liver function. Perinatal mortality was 62.5% in severe preeclamptic patients and 42.85% in eclamptic patients with abnormal liver function. Conclusion: From this study it was found that abnormal liver function in patients with severe preeclampsia and eclampsia, affect both maternal and fetal outcome negatively. Therefore, prior information of liver function in such patients may help to reduce maternal and perinatal mortality and morbidities.
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