International Journal of Clinical Obstetrics and Gynaecology
2021, Vol. 5, Issue 5, Part B
Transamnitis and hepato-splenomegaly in pregnancy with normal feto-maternal outcome: A case report
Author(s): Dr. Kanika Sharma
Abstract: Abnormal values of liver function tests can be seen in 3-5% of pregnancies. Most of the abnormal liver tests in pregnancy are a result of 5 liver diseases unique to pregnancy- heyperemesis gravidarum (HG), intra hepatic cholestasis of pregnancy (ICP), pre-eclampsia, HELLP syndrome and Acute Fatty Liver of Pregnancy (AFLP). This is a case report of 30 year nulligravida who conceived spontaneously after being treated for Poly cystic ovaries. Pre-conceptionaly the patient’s metabolic parameters were within normal range, her BMI was 23.4Kg/m2 at the time of conception. Patient had developed mild COVID related illness and was not on any antibiotics, antivirals or steroids. Patient developed nausea and vomiting of pregnancy at around 8 weeks of gestation. She developed intractable vomiting and was admitted at 15 weeks of gestation with hyperemesis gravidarum and treated accordingly. Patient had elevated liver enzymes at this point of time with her AST = 106 U/L and ALT 94 U/L. Ultrasound upper abdomen showed no gall stones, no organomegaly. Her serum bile acids remained <10µmol/L throughout the pregnancy. She never developed any pruritus either, but her transaminases were consistently raised. She was started on ursodeoxycholic acid which decreased the values but even after this treatment she had transamnitis ultrasound at 24 weeks gestation showed increased liver span and splenomegaly (12cm) but no gall stones. Her viral markers were also negative. She was given steroid cover. Patient went into spontaneous labor and delivered a healthy female child with no post natal complications.