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An Observational Study to Evaluate the Maternal and Foetal Outcomes in Pregnancies Complicated with Jaundice

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Abstract

Background

Incidence of jaundice in pregnancy, including underlying chronic liver diseases, is 3–5%. However, the maternal mortality rate in some conditions can be as high as 18% in acute fatty liver of pregnancy and 22% in hepatitis E in pregnancy.

Objectives

This is an observational study of the demographics, obstetrical profile, aetiology, maternal morbidity, mortality and neonatal outcomes in pregnancies complicated with jaundice.

Materials and Methods

This is an observational study conducted in Department of Obstetrics and Gynaecology of a tertiary care hospital, situated amidst the biggest urban slum in Mumbai spanning over 1 year from January 2016 to December 2016. All registered, unregistered and transferred patients with abnormal liver function tests excluding patients with chronic liver diseases were included in this study.

Results

Most of the cases of jaundice in pregnancy were seen in primigravida (51%) and age group of 20–30 years (58%). Fifty-three percentage of cases were referred or transferred from periphery hospitals. Hepatitis E was the most common cause (42%) of jaundice in pregnancy. Complications like disseminated intravenous coagulopathy, postpartum haemorrhage, hepatic encephalopathy and hepatoportal hypertension were seen in 65% of cases. Maternal mortality rate and perinatal mortality rate were as high as 40 and 37%, respectively, in our study.

Conclusion

Incidence of jaundice in pregnancy, mainly due to viral hepatitis, is very high in lower socio-economic, densely populated urban slums. Special efforts should be made to counsel and educate the mothers about initial symptoms and preventive measures for viral hepatitis. Patients along with the relatives should be informed about the severe features of pre-eclampsia to combat these preventable causes of maternal mortality.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College, Sion, Mumbai, 400022, India

    Pradnya Changede, Niranjan Chavan, Neha Raj & Priyanka Gupta

Authors
  1. Pradnya Changede
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  2. Niranjan Chavan
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  3. Neha Raj
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  4. Priyanka Gupta
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Corresponding author

Correspondence to Pradnya Changede.

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Conflict of interest

None.

Ethical Standards

All procedures performed were with the standard of institutional research ethical committee and the 1964 Helsinki declaration and its later amendments.

Additional information

Dr. Pradnya Changede is currently working as an Assistant Professor in the Department of Obstetrics and Gynecology at Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai-22. Dr. Niranjan Chavan is currently working as Professor (Addl) in the Department of Obstetrics and Gynecology at Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai-22. Dr. Neha Raj is currently working as Registrar in the Department of Obstetrics and Gynecology at Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai-22. Dr. Priyanka Gupta is currently working as Registrar in the Department of Obstetrics and Gynecology at Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai-22.

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Changede, P., Chavan, N., Raj, N. et al. An Observational Study to Evaluate the Maternal and Foetal Outcomes in Pregnancies Complicated with Jaundice. J Obstet Gynecol India 69, 31–36 (2019). https://doi.org/10.1007/s13224-018-1105-9

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  • DOI: https://doi.org/10.1007/s13224-018-1105-9

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