2018, Number 2
Biochemical hepatic alterations in critically ill obstetric patients
Chávez-Ramírez RM, Velarde Ruiz-Velasco JA, Morel-Cerda CE, Velarde-Chávez JA, Lazcano-Becerra M, Rangel-Orozco MF, Mercado-Jáuregui LA, Bocaletti GMM, Gómez-Quiroz OG, Filio-Hermosillo AC, Barajas-Correa DI
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Language: Spanish
References: 9
Page: 66-70
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ABSTRACT
Introduction. Abnormal liver test during pregnancy can be related to multiple causes, being the liver diseases unique to the pregnant state the most frequent. This group of pathologies include hyperemesis gravidarum, preeclampsia-eclampsia, intrahepatic cholestasis of pregnancy, HELLP syndrome and acute fatty liver of pregnancy. It is important to identify these entities early because of the impact on the prognosis for both the mother and the fetus.Material and Methods. Descriptive and retrospective study, which included all the patients admitted to the Obstetric Intensive Care Unit during the period from July 2017 to July 2018 and who presented abnormal liver chemistries. The clinical, demographic and laboratory data were taken from the clinical records.
Results 352 patients were admitted and 14.2% had some alteration in liver chemistries. The mean age was 29 ± 3 years and the mean gestational age was 34.7 weeks. Among the liver diseases unique to pregnancy, 75.5% had preeclampsia, HELLP syndrome in 49%, eclampsia in 17% and intrahepatic cholestasis of pregnancy in 3.8%. All the patients presented elevated AST with mean of 181 IU / l, 39.6% in the range of 5-15 times the upper limit of normal (ULN); 90.6% presented ALT elevation with mean of 157 U / l, 39.6% in the range of 2-5 times the ULN. There was no maternal mortality.
Discussion. The liver diseases related to pregnancy are the most frequent cause of alteration in the hepatic profile of this group of patients, especially from the third trimester, with pre-eclampsia-eclampsia being the most prevalent. Most are presented with a mixed pattern of liver injury.
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