A PROSPECTIVE STUDY OF MATERNAL AND FETAL OUTCOME OF VIRAL HEPATITIS IN PREGNANCY (original) (raw)

Study to Determine the Fetal and Maternal Outcome in Acute Viral Hepatitis

International Journal of Medical and Biomedical Studies

Acute viral hepatitis is the commonest cause of jaundice in pregnant women with clinical evidence of hepatitis with HEV being the predominant cause. Acute viral hepatitis is a systemic infection caused by six distinct types of viruses A, B, C, D, E and G. The present study was a prospective observational study done in the Department of Obstetrics and Gynaecology, Patna Medical College & Hospital, Patna over a 2 years period with 100 pregnant patients suffering from acute viral hepatitis. This study was conducted to know the prevalence, obstetric complications and maternal, perinatal outcome in pregnant women presenting with acute viral hepatitis. In our setup most common cause of acute viral hepatitis with adverse fetomaternal outcome was found to be with Hepatitis E .HBV was found to be the 2rd most common etiological factor followed by HAV. Adverse fetomaternal outcome like abortion, preterm, LBW, IUGR, IUD, higher NICU admissions, coagulation derangement, PPH, hepatic encephalopa...

Acute viral hepatitis in pregnancy

International Journal of Gynecology & Obstetrics, 1993

Introdllction OBJECTIVE: To describe the clinical outcome of pregnancy and vertical transmission of acute viral hepatitis in pregnancy. METHODS: Forty-eight pregnant patients with acute viral hepatitis were evaluated clinically and by abdominal ultrasonography. Serological studies for hepatitis markers were performed using radioimmunoassay. The results were evaluated using Student's t-test and tests of proportion. RESULT: Thirty-jive (72.9%) delivered live birth babies at term, while 13 (27.1%) had fetal complications an&or losses. The percen tage of fetal complications and/or losses was higher in patients who had non-A, non-B hepatitis (30.8%) than those who had type B hepatitis (25%). The most common fetal complication was premature delivery (14.9%) followed by stillbirth and abortion (8.3%) for each. The overall percentage of vertical transmission of hepatitis B virus was 2 out of 27 (7.4%). CONCLUSION: Acute viral hepatitis carries a high risk for both mother and fetus. Routine vaccination of all susceptible women and babies against hepatitis B is recommended in endemic areas.

Maternal and fetal outcome in pregnancy with hepatitis E virus infection

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016

Background: Hepatitis E infection has been a major concern in the pregnant females due to its fulminant nature in pregnancy and increased mortality in pregnant females as compared the non-pregnant females and males. In spite of approximately 60 years of its discovery the cause of fulminant nature of hepatitis E in pregnancy still remains a mystery. The maternal and fetal outcomes are still unfavorable. Various studies and hypothesis have been given but still not proved. Hence the study was performed in tertiary care centre to evaluate the maternal and fetal outcome in pregnancy with hepatitis E virus infection. Methods: All cases of hepatitis E, IgM positive visiting the antenatal clinic or admitted during the period of 2012 and 2014 at the tertiary care centre were included in the study. Other cases of hepatitis (noninfectious, other causes of viral hepatitis) were excluded. Maternal outcome in terms of acute liver failure, coagulation failure, hepatic encephalopathy and maternal mortality was studied. Fetal outcome in terms of, preterm labor, low birth weight, intrauterine fetal death was studied. Results: In the study it was found that pregnant women with jaundice and acute viral hepatitis due to hepatitis E virus infection had a high mortality rate (52%), especially during third trimester and postpartum period (82%). The most common medical complication was coagulation failure (56%) and acute liver failure (27%) followed by hepatic encephalopathy (17%). The most common obstetric complication was post-partum hemorrhage (42%) followed by IUFD (24%), APH (8%). Conclusions: The study shows that pregnant women with jaundice and acute viral hepatitis due to hepatitis E virus infection had a high mortality rate especially during third trimester and postpartum period and also they had poor obstetric and fetal outcome.

Study of Hepatitis-E in Pregnancy : Maternal and Fetal Outcome Dr

2019

HEV infection, a major public health concern, is known to cause large scale epidemic and sporadic cases of acute viral hepatitis in developing countries. The infection primarily occurs in young adults and is generally mild and self-limiting, case fatality is higher when it occurs during pregnancy specifically in 2 and 3 trimester. Hepatitis E infection during pregnancy, especially in the third trimester, is characterized by a more severe infection that sometimes results in fulminant hepatitis, increasing maternal and fetal mortality and morbidity.

Analysis of prognosis-associated factors in fulminant viral hepatitis during pregnancy in China

International Journal of Gynecology & Obstetrics, 2011

Objective: To analyze factors contributing to the prognosis of patients with fulminant viral hepatitis in pregnancy (FVHP). Methods: A retrospective study was conducted among 90 patients with FVHP who were admitted between January 1994 and August 2008 in 9 Chinese hospitals with expertise in the treatment of FVHP. Results: Different clinical types of FVHP presented with different fatality rates; the acute type showed the highest fatality rate and the chronic type showed the lowest fatality rate. Serum albumin (Alb), total cholesterol (Tch), total bilirubin (Tbil), prothrombin activity (PTA), creatinine (Scr), white blood cell count (WBC), the phenomenon of "bilirubin-transaminase separation", and intractable complications correlated with the prognosis of FVHP. The fatality rate increased with decreasing Tch and PTA, increasing WBC, the appearance of "bilirubin-transaminase separation", and complications such as hepatic encephalopathy, hepatorenal syndrome, hemorrhage, and infection. The above indices were all significantly different between survivor and non-survivor groups. Conclusion: The clinical type of fulminant hepatitis, Alb, Tch, PTA, TBIL, Scr WBC, phenomenon of "bilirubin-transaminase separation", and intractable complications are important factors associated with prognosis of patients with FVHP. Dynamic monitoring of these indicators and active treatment of complications are key to the improvement of outcomes in patients with FVHP.

Study of maternal and prenatal outcome in pregnant women with acute hepatitis E viral infection

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016

Background: Hepatitis E Virus (HEV) is a major aspect of hepatitis and death in the developing countries and asymmetrical source of deaths in among of pregnant women. The objective of this study was to determine the maternal and prenatal outcome in pregnant women with acute hepatitis E viral infection in Malwa, India. Methods: Observational, cross-sectional study. The study population was pregnant women with acute hepatitis E infection confirmed by ELISA technique. Pregnant women with other hepatic viral infections were excluded. All medical and obstetric conditions and mortality were noted on the predesigned proforma. Results: Out of the total 105 admitted pregnant women with hepatitis E viral infection, 21.90% women had severe morbidity, 24.17% perinatal death and 14 (13.3%) expired before delivery. The yellowish discoloration of urine or sclera was observed in 91.42% with abdominal pain in 76.19%. Maternal mortality was higher in patients with primi (47.82%) and patients presented in second trimester (56.50%). Conclusions: The acute viral hepatitis E infection in pregnant women is associated with maternal morbidities and high mortality rate.

Clinical course and management of acute and chronic viral hepatitis during pregnancy

Journal of viral hepatitis, 2014

Pregnancy is a para-physiologic condition, which usually evolves without any complications in the majority of women, even if in some circumstances moderate or severe clinical problems can also occur. Among complications occurring during the second and the third trimester very important are those considered as concurrent to pregnancy such as hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, HELLP syndrome and acute fatty liver of pregnancy. The liver diseases concurrent to pregnancy typically occur at specific times during the gestation and they may lead to significant maternal and foetal morbidity and mortality. Commonly, delivery of the foetus, even preterm, usually terminates the progression of these disorders. All chronic liver diseases, such as chronic viral hepatitis, autoimmune hepatitis, Wilson's disease, and cirrhosis of different aetiologies may cause liver damage, independently from pregnancy. In this review we will also comment the clinical implications o...

Comparison of foeto-maternal outcome in pregnant women with hepatitis E - A review of 12 years

JPMA. The Journal of the Pakistan Medical Association, 2017

OBJECTIVE To compare adverse maternal and foetal outcome in pregnant women with hepatitis E immunoglobulin M reactive versus non-reactive. METHODS This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of pregnant patients at any gestational age with clinical and biochemical evidence of hepatitis E from January 2002 and December 2014. . Maternal and perinatal outcome of the subjects were analysed. SPSS 20 was used for data analysis. RESULTS Out of the 200 subjects, 168(84 %) were hepatitis E immunoglobulin M reactive and 32(16%) were non-reactive. The overall mean age was 26.7±4.5 years. Also, 12(7%) patients in the immunoglobulin M reactive group were admitted to intensive care unit compared to no one from the non-reactive group. Similarly fulminant hepatic failure was seen in 12(7.1%) patients in the immunoglobulin M reactive group compared to no one in the other group. Post-partum haemorrhage was more frequent in the immunoglobu...