PERINATOLOGIYA I PEDIATRIYA. 2016.3(67):23-27; doi 10.15574/PP.2016.67.23 
 

The course of pregnancy, childbirth and postpartum period in women with diseases of the hepatobiliary system 
 

Golyanovskyy O. V., Juravlyova L. A., Savonik A. O.

Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine 
 

Objective is to study the effect of the hepatobiliary system diseases on the pregnancy course, childbirth, the postpartum period and newborn state.

Patients and methods. The study was conducted at clinical sites of the Obstetrics and Gynaecology Department No.1 of the P.L. Shupyk National Medical Academy of Postgraduate Education; The 13,124 cases of births for the period 2011-2015 have been analyzed. In general, were identified 736 (5.6%) cases with different pathology of the liver and biliary tract. The vast majority of patients (621, or 84.6%) were pregnant women with chronic inflammatory diseases of the hepatobiliary system (first cohort group). To the second cohort group were included pregnant women (300 women) without the manifestation of the present disease. Study groups were represented by the main indicators (age, parity, according to the gynecological diseases etc.). All pregnant women had passed fully clinical and laboratory examinations. They held general clinical (clinico-anamnestic and laboratory examinations) and special (ultrasound examination with Doppler velocimetry and cardiotocography) studies.

Results. Comparing the pregnancy course of the main and control groups was found that pregnant women with diseases of the hepatobiliary system had more frequent manifestations of: preeclampsia (in 3 times), the threat of termination of pregnancy and miscarriages (in 5 times), and fetoplacental insufficiency (in 2.5 times). In addition, in patients with diseases of the hepatobiliary system in comparison with healthy patients preterm delivery were more frequent — in 7 times, the weakness of labor activity – in 4 times, and bleeding — in 3 times. Most of the pregnancies were at term, when among the patients with diseases of the hepatobiliary system the percentage of preterm birth was higher. Fetal growth retardation was observed in 4.5 times more frequently in the group of patients with diseases of the hepatobiliary system, just as infants mortality was higher in the 6 times.

Conclusions. State of the hepatobiliary system, directly or indirectly has the effect on all stages of pregnancy, childbirth and newborn state. Timely large and correct diagnosis of the liver lesions during the pregnancy, risk assessment of maternal and perinatal pathology in each case is needful for the right choice of correct tactics of labor management and prevention of complications during the pregnancy.

Key words: hepatobiliary system hepatocholecystitis, hepatocholecystitis angiolith.

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