Frequency of Altered Liver Function Tests in Hyperemesis Gravidarum During First Trimester

Abstract

Objective: To determine the frequency of abnormal liver function tests (LFTs) in hyperemesis gravidarum (HG) during first trimester.

Study Design: Descriptive cross sectional study

Place and Duration of Study: This study was conducted at Gynecology and Obstetrics Department of Bahawal Victoria Hospital in collaboration with Pathology Department, Quaid-e-Azam Medical College from March 2020 to September 2021 for a period of six months.

Materials and Methods: Total 106 pregnant women in their first trimester, presenting with hyperemesis gravidarum were enrolled in the study. Liver function tests of all study subjects were evaluated including total serum bilirubin, alanine transaminases (ALT) and aspartate transaminases (AST).

Results: The results of this study showed a mild increase in serum total bilirubin (1.4±0.4) and a mild to four times elevation in level of serum transaminases i.e. ALT (57.2±39.3) and AST (48.4±28.7). An elevated level of ALT was observed in multiple pregnancies.

Conclusion: Hyperemesis gravidarum is associated with alteration in liver function tests. These abnormalities are mild and resolve after the cessation of symptoms. Persistent elevation warrants further investigation to rule out underlying hepatic disease. The severity of symptoms correlates with degree of derangement. Outcome of HG remains unaffected and only conservative management is required. Moreover, the significant increase in serum ALT levels in multiple pregnancies may suggest a relationship with pregnancy hormones.