THE EFFECT OF INTRAPARTUM BLOOD LOSS ON LIVER FUNCTION IN PATIENTS WITH ACUTE KIDNEY INJURY IN THE OLIGOANURIC STAGE

Objective. To assess the characteristics and severity of changes in liver function according to the volume of intrapartum blood loss in women with acute kidney injury (AKI) in the oligoanuric stage.

Materials and methods. The provided clinical dataset included 102 patients. Intrapartum blood loss ranged from 400 to 3000 ml, with a mean of 1238.2±151.9 ml. Patients were divided into four groups according to blood loss: 400–900 ml (n=14), 1000–1500 ml (n=31), 1600–2400 ml (n=36), and more than 2500 ml (n=21). Liver function was assessed using blood biochemical parameters, lactate dehydrogenase (LDH) and its isoenzymes, bromsulphalein tests, and fractional hepatic blood-flow measurements.

Results. Increasing blood loss was accompanied by a trend toward more pronounced laboratory and specific functional signs of liver injury. In group IV, total bilirubin was 23.41±0.78 μmol/L, AST 211.12±7.2, and ALT 408.36±14.0 (units as reported in the source material); the prothrombin complex decreased to 59.4±2.0%. Moderate and marked impairment of detoxification and uptake-excretory functions was more frequently observed in groups with greater blood loss.

Conclusion. In patients with AKI in the oligoanuric stage, the volume of intrapartum blood loss may be associated with the severity of liver functional impairment. A comprehensive assessment should combine routine biochemical tests with specific functional tests and evaluation of hepatic perfusion.