SONOGRAPHIC EVALUATION OF THE LIVER IN PREGNANT WOMEN
ABSTRACT
The variations in the sizes of the various organs during pregnancy is well known with various organs of the body increasing in size throughout pregnancy and returning to their pre-pregnant state during the pueperium. The purpose of this research was to investigate on the ultrasonographic evaluation of the liver in pregnant women at the Agbor General Hospital. The study was a cross-sectional survey of pregnant women with data obtained from the Agbor General Hospital. We investigated a total of one hundred and fifty (150) subjects and the result was analyzed with the aid of the Statistical Package for Social Science version 20.0. Ethical clearance was obtained from the Research and Ethics Committee of Human Anatomy Department in Delta State, University, Abraka. From the results; an average mean ± standard deviation was gotten for the pregnant female patients as regards liver length. The study showed apositive correlation between the liver lengths but not with gestational age and also a significant difference in the liver length as regards the age groups and with second and third trimester.
CHAPTER ONE
INTRODUCTION
1.1Â Â Â Â Â Background of Study
The variations in the sizes of the various organs during pregnancy is well known with various organs of the body lincreasing in size throughout pregnancy and returning to their pre-pregnant state during the pueperium (Melamedet al., 2011). The liver is the largest abdominal organ with function in filtering and storage of blood, metabolizing of carbohydrates, proteins, hormones and strange chemicals; to form bile, storage of vitamins and iron; and production of clothing factors. Also, the liver size estimation is important in the diagnosis and follow up of various disease occurring in pregnancy like hepatitis, and hypertensive diseases of pregnancy (Wennet, 2001). Thus, the knowledge of the normal sonographic liver size is important.
Ultrasonography is the best method for the assessment of abdominal organs during pregnancy as it is non-invasive non-ionizing thus safe in pregnancy. It is also readily available, quick, cheap and accurate (Kerstin and Brennan 1992). Examination is in real time, three-dimensional and independent of organ function thus the internal structures can be assessed easily. It has advantages over other radiological imaging modalities such as conventional radiography and computed axial tomography in that ionizing rays which are harmful to the developing fetus are used. With ultrasound, sound energy is used and has been found to have no adverse effect on the developing fetus, thus it is safe. It can be used at any stage of pregnancy (Miller et al., 1984). Physical examination of the liver through palpation and percussion is less accurate compared to ultrasound estimation of the size especially in detecting small increases in size (Rosemeriet al.,2010).
The liver occupies 5% of the mature fetus body cavity and it constitutes 2.5% of the adult body weight (Ronald, 2003). Liver weight in the adult male is approximately 1400-1500g2 and it serves over 500 physiological functions related to metabolism, digestion, immunity and storage of nutrients (Moore, et al., 2010).
Conventional and pulsed color Doppler ultrasonography are considered to be indicated for the study of gestation and maternal organs on account of the multiplicity of morphological and hemodynamic data that they provide for being innocuous for their noninvasive and relatively low cost. The Doppler modality is utilized for qualitative and quantitative evaluation of the arterial and venous perfusion and can increase the ultrasonography accuracy, identifying the blood flow in the vessels and their respective resistivity and pulsatility indices as well as the study of their indices in the physiological alterations observed during pregnancy.
Accurate measurement of the liver by sonography is particularly relevant when hepatic diseases are suspected. As a noninvasive and inexpensive method, when compared to other methods (Tchelepici, et al., 2002), diagnostic sonography is particularly useful to evaluate liver size and texture. In recent years, diagnostic sonography has shown specificity and positive predictive value in assessing the liver and its various diseases (Hung, et al., 2003). But according to a number of validated sources, measurements of liver length still varies greatly across modalities and techniques used by the operator (Rumack, et al., 2011).
