LIVER FUNCTION TESTS IN PREECLAMPSIA
AbstractBackground: Preeclampsia is a multisystem disorder that can induce damage to cardiovascular system,kidneys, brain and liver. Pregnancy-induced hypertension (PIH) is responsible for significant maternaland perinatal morbidity. This study was conducted to compare the liver function tests in preeclampsiawith normal pregnancy. Methods: This study was carried out on 100 pregnant women after 20 weeks ofgestation admitted in Obs/Gyn units of Ayub Teaching Hospital, Abbottabad. The subjects were dividedinto two groups. Group A consisted of 50 cases of preeclampsia having blood pressure 140/90 mmHg,proteinuria in 24 hours 300 mg and oedema; Group B had 50 normal pregnant women after 20 weeksof gestation. The data including BMI, parity, period of gestation, blood pressure and presentingcomplaints of all subjects were recorded. Serum bilirubin and plasma levels of liver enzymes ALT, ASTand ALK were measured. Results: The mean BMI of the cases was 29.04±3.97 and that of controls was26.54±3.11. The mean value of serum bilirubin in cases was 10.78±3.74 µmol/L and in controls it was7.92±2.42 µmol/L (p<0.001). The mean values of enzyme ALT in cases was 55.81±31.93 U/L while inthe controls it was 15.22±3.30 U/L (p<0.001). Mean serum AST in the cases was 41.34±10.76 U/L andin the controls it was 24±2.54 U/L (p<0.001). Mean ALK level of cases before delivery was454.16±243.69 U/L, and in controls it was 181.34±66.76 U/L (p<0.001). Conclusion: Raised levels ofserum bilirubin and liver enzymes ALT, AST and ALK were found in preeclampsia cases.Keyword: Preeclampsia, Liver Function Tests, Pregnancy, Hypertension, Morbidity, Women
Coppage KH, Sibai BM. Treatment of hypertensive complications
in pregnancy. Curr Pharm Des 2005;11(6):749–57.
Mackay AP, Berg CJ, Atrash HK. Pregnancy related mortality
from preeclampsia and eclampsia. Am J Obstet Gynecol
National High Blood Pressure Education Program. Working
Group on High Blood Pressure in Pregnancy. Report of the
National High Blood Pressure Education Program. Working
Group on High Blood Pressure in Pregnancy. Am J Obstet
Davey DA, Mac Gillivray I. The Classification and definition of
the hypertensive disorders of pregnancy. Am J Obstet Gynecol
ACOG Committee on Obstetric Practice. ACOG practice
bulletin. Diagnosis and management of preeclampsia and
eclampsia. Obstet Gynecol 2002;99(1):159–67.
Kwiatowski S, Kwiatkowska E, Czajka R, Ciechanowski K,
Kedzierska K, Bober J, et al. The activity of erythrocyte sodiumproton exchanger in women with pregnancy-induced
hypertension. Hypertens Pregnancy 2006;25(1):37–46.
Cnossen JS, van der Post JA, Mol BW, Khan KS, Meads CA, ter
Riet G. Prediction of pre-eclampsia: a protocol for systematic
reviews of test accuracy. BMC Pregnancy Childbirth 2006;6:29.
Lenfant C; National Education Program Working Group on High
Blood Pressure in Pregnancy. Working Group Report on High
blood pressure in pregnancy. J Clin Hypertens (Greenwich)
Wetzka B, Nusing R, Charnock DS, Janes Schafer W, Zahradni
HP, Smith SK. Cycloxygenase-1-and 2 in a human placenta and
placental bed after normal and preeclamptic pregnancies. Human
Mills JL, DerSimonian R, Raymond E, Morrow JD, Roberts LJ,
Clemens JD, et al. Prostacyclin and thromboxane changes
predating clinical onset of preeclampsia: a multicenter
prospective study. JAMA 1999;282:356–62.
Wang Y, Walsh SW. Increased superoxide generation is
associated with decreased superoxide dismutase activity and
mRNA expression in placental trophoblast cells in pre-eclampsia.
Angel Gracia AL. Effect of pregnancy on pre-existing liver
disease Physiological changes during pregnancy. Ann Hepatol
Burroughs AK. Pregnancy and liver disease. Forum (Genova)
Weinstein L. Syndrome of hemolysis, elevated liver enzymes and
low platelet count a severe consequence of hypertension in
pregnancy. Am J Obstet Gynecol 1982;142:159–67.
Simith LG Jr, Moise KH Jr, Dildy GA III, Carpenter RJ Jr.
Spontaneous rupture of liver during pregnancy: current therapy.
Obstet Gynecol 1991;77:171–5.
López-Jaramillo P. Casas JP, Serrano N. Preeclampsia: from
epidemiological observation to molecular mechanism. Broz J
Med Biol Res 2001;34(10):1227–35.
Kaaja R. Predictors and risk factors of preeclampsia. Minerva.
Hauger MS, Gibbons L, Vik T, Belizan JM. Pregnancy weight
status and risk of adverse pregnancy outcome. Acta Obstet
Gynecol Scand 2008;87(9):453–9.
Noreen A, Rana G. Women with pregnancy induced
hypertension: epidemiological difference between normotensive
pregnant women. Professional Med J 2006;13(2):310–2.
Malvino E, Munoz M, Ceccottic C, Janello G, Mc Loughlin D,
Pawlak A, et al. Maternal morbidity and perinatal mortality in
HE LLP Syndrome (Multicentric studies in intensive care units in
Buenos Aires area). Medicina (B Aires) 2005;65(1):17–23.
Jaleel A, Baseer A, Aamir S. Biochemical parameters for
detection of hemolysis in pregnancy induced hypertensive
women. J Coll Physicians Surg Pak 1999;9(1):41–2.
Knapen MF, Mulder TP, Bisseling JG, Penders RH, Peters WH,
Steegers EA. Plasma glutathione-s-Transferase Alpha-1-1. A
more sensitive marker for hepatocelluar damage than serum
alanine aminotransferase in hypertensive disorder of pregnancy.
Am J Obstet Gynecol 1998;178(1):161–5.
Mahmoudi N, Graves SW, Solomon CG, Repke JT, Seely EW.
Eclampsia: A 13-year experience at a United States tertiary care
Centre. J Womens Health Gender Base Med 1999;8:495–500.
Haddad B, Barton JR, Livingston JC, Chahine R, Sibai BM. Risk
factors for adverse maternal out comes among women with
HELLP (hemolysis, elevated liver enzymes and low platelet
count) Syndrome. Am J Obstet Gynecol 2000;183:444–8.
Rath W, Faridi A, Dudenhausen JW. HELLP Syndrome. J
Perinat Med 2000;28(4):249–60.
Kim JH, Kwon CI, Ko EH, Kim DY, Kim HY, Jung SH, et al.
Abnormal liver function tests in pregnancy. Korean J