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The purpose of this study was to examine (a) the incidence of liver disease diagnosed in our antenatal population, (b) the diagnostic value of initial symptoms and liver function tests (LFTs), (c) the adequacy of investigation and management of the liver disorder and (d) the obstetric and neonatal outcome in this group of patients. Women with abnormal LFTs that delivered at our hospital over a 2-year period were identified from computerised hospital records and data was obtained from chart review. Forty-six out of a total of 13 181 (0.35%) women had liver disease diagnosed in pregnancy: Diagnoses included intrahepatic cholestasis of pregnancy (13), pre-eclampsia and the HELLP syndrome (eight), acute fatty liver of pregnancy (three), hyperemesis gravidarum (one), hepatitis C (13), B (four) and hepatitis A (one), cholelithiasis (two) and hepatitis of unknown aetiology (one). Symptoms at presentation were more predictive of the final diagnosis than the initial LFT profile. Investigation of the liver disorder was incomplete in 50% of cases.One mother required intensive care for 6 weeks postpartum and three others had significant postpartum haemorrhage. There was one neonatal death and 24 neonates were admitted to the special care baby unit. Eighteen women attended for their postnatal check up at 6 weeks. Eight of these women were referred to a hepatologist. Detection of liver disease in pregnancy identifies a group at risk of poor neonatal and maternal outcome. Structured guidelines should be implemented in obstetric units to facilitate appropriate investigation, treatment and referral patterns for these women. [ABSTRACT FROM AUTHOR]

The article reports on an early diagnosis of a complete hydatidiform mole in a twin pregnancy with a viable fetus by researchers from Worthing, England. The incidence of complete or partial hydatidiform moles is 1 per 714 live births in Great Britain. However, the incidence of a hydatidiform mole co-existing with a viable fetus is a much rarer event. The plausibility for a first trimester diagnosis of gestational trophoblastic neoplasia in a twin pregnancy is very rare, even with improved imaging. Researchers recommend referral to national centers for a successful management.

An abstract of the article "Antenatal detection of aneuploidy in Merseyside and Cheshire," by G. Edwards and Z. Alfirevic is presented. The audit herein aims to review all cases of aneuploidy reported to the Merseyside and Cheshire Congenital Anomaly Survey and evaluates the effectiveness of antenatal screening policies. It was discovered that detection of aneuploidies in the Mersey Region in 1997 was less than the expected standard.