Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy* (original) (raw)
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A PROSPECTIVE STUDY OF MATERNAL AND FETAL OUTCOME OF VIRAL HEPATITIS IN PREGNANCY
This study was conducted to evaluate the causes ,clinical course & feto-maternal outcome and prognostic factors affecting the outcome in cases of viral hepatitis in pregnancy. Methods: Sixty-one pregnant women reporting to the hospital with hepatitis during the study period of 2 years from January 2015 to December 2016 were enrolled as cases and their haematological, biochemical and viral profiles were studied. A comparison was done between the survivors and non-survivors and factors predicting mortality were studied . The unpaired student t test and fischre exact test were used to find out whether the differences were statistically significant. Results: Most of the patients were primigravida (51 %) and were in the third trimester of pregnancy(82%).Viral Hepatitis in pregnancy caused a very high maternal mortality (18%). Hepatitis E virus was the commonest causative organism (55%) responsible for viral hepatitis during pregnancy. It also caused the highest maternal mortality due to fulminant hepatic failure. Maternal mortality was significantly higher in those women presenting with features of encephalopathy, high bilirubin levels, high liver enzymes and prolonged prothrombin time. Conclusions: Hepatitis E is the chief causative organism causing fulminant hepatic failure in pregnant women.
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.
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...
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...
Journal of Turkish Society of Obstetric and Gynecology
Amaç: Hepatit, gelişmekte olan ülkelerde sık görülen bir enfeksiyondur. Hepatit B ve C, köklerini gelişmiş dünyada derinleştirirken, hepatit A ve E gelişmekte olan dünyada sık görülmektedir. Hepatitin kendine özgü özelliği, gebelik olmayan durumda nispeten kendi kendini sınırlayan bir hastalıktan, gebelik esnasında bir şekilde yüksek düzeyde virülan bir hastalığa dönüşmesidir. Gereç ve Yöntemler: Bu retrospektif gözlemsel çalışma, Haziran 2016 ile Kasım 2016 tarihleri arasında altı aylık bir sürede [muhtemelen hepatit E virüsünün (HEV) endemik olarak pik yaptığı dönemde] King George Tıp Üniversitesi (Lucknow), Kadın ve Doğum Hastalıkları Anabilim Dalı'nda, HEV ile enfekte olmuş gebe kadınlarda klinik prognozları gözlemlemek üzere yürütülmüştür. Bulgular: Toplam 32 anti-HEV immünoglobulin M-pozitif gebe kadın çalışmaya dahil edilmiştir ve fetomaternal prognozlar analiz edilmiştir. Hepatit E pozitifliği, maternal mortalite ile anlamlı derecede ilişkili bulunmuştur ve en sık belirlenen fetal komplikasyonlar prematürite ile birlikte intrauterin ölüm ve erken membran rüptürü olmuştur. Sonuç: Enfeksiyon virülansının derecesinde ve maternal morbidite, mortalite ve intrauterin ölüm oranlarında farklılıklar, etkili olabilecek ve daha fazla incelenmesi ve değerlendirilmesi gereken bazı faktörlere işaret etmektedir.
Viral Hepatitis during Pregnancy: A Study of Its Socio- Clinical Profile in A Tertiary Care Hospital
IOSR Journal of Dental and Medical Sciences
To determine the incidence of hepatitis in pregnancy and its association with various social, personal and environmental risk factors, a study was conducted at a Tertiary Maternity Care Hospital, Srinagar. During the one year study period patient selection was based on presence of clinical features suggestive of liver disease. The suspected patients were subjected to liver function tests and hepatitis serology (hepatitis A, hepatitis E, hepatitis B, hepatitis C) for diagnosis. The incidence of viral hepatitis was found to be 0.8 per 1000 pregnant women and etiology in all cases was Hepatitis B viral infection. Fortunately none of the pregnant women had positive hepatitis E serology which has a fatal outcome in pregnancy. Pregnant women who are positive for Hepatitis B viral infection needs to be closely followed up for the adverse perinatal outcome and chronic morbidity associated with the condition. Risk factors associated with the development of infection were prevalent in the form of parental drug use, dental extractions, blood transfusion, residence at endemic areas and poor food hygiene. Sociodemographic variables and risk factors were found to have significant association with hepatitis. Hepatitis patients were mostly anicteric showing inadequacy of serum bilirubin in diagnosis. Screening for hepatitis in future should become an important component of antenatal care.
Acute Hepatitis in Pregnancy: A Case Report
Asploro Journal of Biomedical and Clinical Case Reports, 2020
Introduction: Several changes occur in women’s body during pregnancy, as well as several pathologies can arise at this period, such as hepatitis. It is very important to have the correct diagnosis and proper treatment for pregnant women because liver diseases can increase maternal and/or fetal morbidity and mortality rates. Case Report: Patient in the age group 32 years, G2P0A1, thrombophilic, using ASA, enoxaparin, folate, and B-complex, reported jaundice, low fever, and pruritus in the 32nd week of pregnancy. Laboratory exams showed high levels of direct hyperbilirubinemia and aminotransferases, with negative serology results for the most common viruses and autoimmunity markers. Hypervitaminosis B12 was an additional finding; it was canceled. The patient had a satisfactory recovery after support treatment. Discussion: Hepatitis has several etiologies; it is caused by infections, medications, or triggered by the immune system. The main infectious agents causing hepatitis A, B, C, and E; Dengue, Zika, HTLV, cytomegalovirus, toxoplasmosis, rubella, and brucellosis were screened in the reported case – the patient was negative for all of them. Other possible diagnoses, such as acute liver steatosis of pregnancy, portal thrombosis, and autoimmune hepatitis were excluded. Hepatitis caused by medicines was not confirmed because clinical and laboratory exams showed improvement in the patient’s clinical condition even with ASA and enoxaparin administration. The patient had high vitamin B12 level, which can be a liver damage marker. Transaminases and bilirubin showed a progressive decrease after the treatment; both patient and newborn had a satisfactory recovery. The reported condition was caused by a combination of factors, such as pregnancy hormone levels, unidentified infection, and possible predisposition to develop the disease. The patient remains under hematological and hepatological follow up, but there is no record of relapse, so far.
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.