CLINICAL COURSE OF LABOUR IN WOMEN WITH NON-ALCOHOLIC STEATOHEPATITIS AGAINST THE BACKGROUND OF OBESITY OF VARIOUS DEGREES
DOI:
https://doi.org/10.11603/24116-4944.2022.2.13482Keywords:
non-alcoholic steatohepatitis, obesity, labour complications, non-invasive diagnosticsAbstract
The aim of the study – to evaluate the clinical course of delivery in women with non-alcoholic steatohepatitis against the background of obesity of various degrees.
Materials and Methods. We examined 98 pregnant women with nonalcoholic steatohepatitis (NASH) in combination with obesity. The control group consisted of 30 practically healthy pregnant women. All pregnant women are divided into 3 groups depending on the body mass index (BMI): IA group – 26 patients with a BMI of 25–29.9 kg/m², IB group – 48 pregnant women with a BMI of 30–34.9 kg/m², IC group – 24 pregnant women with a BMI of 35–39.9 kg/m². To assess the presence and severity of steatosis and steatohepatitis, liver elastography with steatometry and the non-invasive test NASH-FibroTest were performed.
Results and Discussion. During the analysis of the course of childbirth, preterm labour was observed in the IA group 1.7 times, in the IB group 2.5 times, in the IC group 3.1 times more often than in the control group (p<0.05), primary . labor weakness occurred 1.1 times more often in the IA group, 3.1 times in the IB group, and 3.7 times more often in the IC group than in the control pregnant group (p<0.05). Postpartum bleeding developed in patients of group IA 2.3 times, group IB – 3.7 times, and group IC – 5.0 times more than in pregnant control groups (p<0.05), and a clinically narrow pelvis . was diagnosed in women with increased body weight 3.8 times more often, in pregnant women with obesity of the first degree 6.2 times, and in patients with obesity of the II–III degree 8.3 times more often than in the control group (p<0.05).
Conclusions. The clinical course of delivery in a parturient with NASH on the background of obesity is accompanied by a significantly higher frequency of obstetric and perinatal complications, which are positively correlated with BMI growth and indicate the severity of NASH during pregnancy.
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