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Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review

BACKGROUND: Epidemiology of liver disease in obstetric patients shows geographical variation depending upon the prevalence of preeclampsia, viral hepatitis, and tropical vector-borne diseases like malaria, leptospirosis, etc. We undertook the current systematic review to analyze the causes of hepati...

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Autores principales: Ahmed, Armin, Saxena, Sulekha, Pandey, Amita, Mishra, Prabhakar, Azim, Afzal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783245/
https://www.ncbi.nlm.nih.gov/pubmed/35110854
http://dx.doi.org/10.5005/jp-journals-10071-24083
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author Ahmed, Armin
Saxena, Sulekha
Pandey, Amita
Mishra, Prabhakar
Azim, Afzal
author_facet Ahmed, Armin
Saxena, Sulekha
Pandey, Amita
Mishra, Prabhakar
Azim, Afzal
author_sort Ahmed, Armin
collection PubMed
description BACKGROUND: Epidemiology of liver disease in obstetric patients shows geographical variation depending upon the prevalence of preeclampsia, viral hepatitis, and tropical vector-borne diseases like malaria, leptospirosis, etc. We undertook the current systematic review to analyze the causes of hepatic dysfunction in obstetric patients in India and identify the gaps in the literature and reporting. MATERIALS AND METHODS: We did a systematic review of studies reporting the causes of hepatic dysfunction in obstetric patients in India. A methodological quality assessment was done using a five-point questionnaire. RESULTS: A total of 21 studies qualified for evaluation. The rate of hepatic dysfunction among obstetric patients in India ranged from 0.15 to 3.3% with a mean and median rate of 1.49 and 0.93%, respectively. Preeclampsia/HELLP (mean = 36.0%, median = 31.4%, range: 3.6–83.8%) and viral hepatitis (mean = 34.1%, median = 35.5%, range: 5.1–61.8%) were the commonest causes of hepatic dysfunction. Other causes were intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, tropical fever (malaria, leptospirosis, dengue, scrub typhus), etc. Maternal mortality ranged from 1.4 to 40% (mean = 12.6%, median = 10.0%) and perinatal mortality was between 16.4 and 38.70% (mean = 31.75%, median = 35.5%). CONCLUSION: There is moderate quality evidence to show that preeclampsia/HELLP and viral hepatitis are the commonest causes of hepatic dysfunction in obstetric patients in India. HOW TO CITE THIS ARTICLE: Ahmed A, Saxena S, Pandey A, Mishra P, Azim A. Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review. Indian J Crit Care Med 2022;26(1):114–122.
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spelling pubmed-87832452022-02-01 Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review Ahmed, Armin Saxena, Sulekha Pandey, Amita Mishra, Prabhakar Azim, Afzal Indian J Crit Care Med Systematic Review BACKGROUND: Epidemiology of liver disease in obstetric patients shows geographical variation depending upon the prevalence of preeclampsia, viral hepatitis, and tropical vector-borne diseases like malaria, leptospirosis, etc. We undertook the current systematic review to analyze the causes of hepatic dysfunction in obstetric patients in India and identify the gaps in the literature and reporting. MATERIALS AND METHODS: We did a systematic review of studies reporting the causes of hepatic dysfunction in obstetric patients in India. A methodological quality assessment was done using a five-point questionnaire. RESULTS: A total of 21 studies qualified for evaluation. The rate of hepatic dysfunction among obstetric patients in India ranged from 0.15 to 3.3% with a mean and median rate of 1.49 and 0.93%, respectively. Preeclampsia/HELLP (mean = 36.0%, median = 31.4%, range: 3.6–83.8%) and viral hepatitis (mean = 34.1%, median = 35.5%, range: 5.1–61.8%) were the commonest causes of hepatic dysfunction. Other causes were intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, tropical fever (malaria, leptospirosis, dengue, scrub typhus), etc. Maternal mortality ranged from 1.4 to 40% (mean = 12.6%, median = 10.0%) and perinatal mortality was between 16.4 and 38.70% (mean = 31.75%, median = 35.5%). CONCLUSION: There is moderate quality evidence to show that preeclampsia/HELLP and viral hepatitis are the commonest causes of hepatic dysfunction in obstetric patients in India. HOW TO CITE THIS ARTICLE: Ahmed A, Saxena S, Pandey A, Mishra P, Azim A. Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review. Indian J Crit Care Med 2022;26(1):114–122. Jaypee Brothers Medical Publishers 2022-01 /pmc/articles/PMC8783245/ /pubmed/35110854 http://dx.doi.org/10.5005/jp-journals-10071-24083 Text en Copyright © 2022; The Author(s). https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated.
spellingShingle Systematic Review
Ahmed, Armin
Saxena, Sulekha
Pandey, Amita
Mishra, Prabhakar
Azim, Afzal
Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review
title Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review
title_full Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review
title_fullStr Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review
title_full_unstemmed Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review
title_short Analysis of Causes of Hepatic Dysfunction in Obstetric Patients in India: A Systematic Review
title_sort analysis of causes of hepatic dysfunction in obstetric patients in india: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783245/
https://www.ncbi.nlm.nih.gov/pubmed/35110854
http://dx.doi.org/10.5005/jp-journals-10071-24083
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