Opportunities for noninvasive diagnosis of liver damage in pregnant women with preeclampsia and HELLP syndrome

Objective. To develop a comprehensive non-invasive diagnosis of liver damage in pregnant women. Materials and methods. A prospective examination was made in 117 pregnant women who were divided into two groups: a study group included women whose pregnancy was complicated by preeclampsia (PE) and HELLP syndrome; a control group consisted of 40 women with uncomplicated pregnancy. Liver function was evaluated using the authors’ designed score scale based on the serum biochemical parameters that most fully reflected the involvement of the liver in metabolic processes. The non-invasive procedure of a “Fibrotest” was first used in pregnant women in order to detect structural changes in liver tissue. Results. All women in the study group were observed to have changes in liver function of varying degrees of severity. As PE increased, the functional state of the liver progressively deteriorated up to an absolute decrease in its function. The detected liver functional changes in PE and HELLP syndrome were accompanied by morphostructural rearrangement in the organ, which is confirmed by Fibrotest results. Conclusion. The authors’ proposed comprehensive assessment of the liver condition using the score scale and the Fibrotest procedure makes it possible to timely detect the extent of liver damage, to choose rational obstetric tactics, to evaluate the efficiency of therapy, and to follow up the reversal of pathological changes in the organ in the postpartum period.

HELLP syndrome, preeclampsia, thrombotic microangiopathy, liver failure in pregnant women, liver damage in pregnant women