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Materno-Fetal Outcomes with Viral Hepatitis in Pregnancy

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Abstract

Objective

To evaluate materno-fetal outcomes in pregnant women with jaundice.

Methods

A prospective study was conducted over a period of 6 months in a tertiary care hospital of Delhi, India. 82 pregnant women with jaundice were included. The serum was screened for viral markers, liver function tests, and coagulation status.

Results

The mean age of women was 27.3 ± 4.3 years. 43.9 % (n = 36) women were HEV positive, 36 % (n = 27) HBsAg positive, 4 % (n = 3) HAV positive and 1.3 % (n = 1) HCV positive. Intrahepatic cholestasis was diagnosed in 10.8 % (n = 8) of women. Maternal morbidity was evaluated in terms of chorioamnionitis (5.4 %, n = 3), encephalopathy (26.8 %, n = 15), and coagulopathy (67.9 %, n = 38). There were five maternal deaths, and all were unbooked with HEV-positive status and a bilirubin >15 mg/dl with deranged coagulogram and encephalopathy and IUDs. 79 women delivered vaginally, and three had cesarean section. Of the vaginal deliveries, 59.8 % (n = 49) went into spontaneous labor, and 25.5 % (n = 21) were induced for varied reasons (BPS < 6/10 (38 %, n = 8)) and progressive derangement of LFT (38 %, n = 8). Among the 71 deliveries, 29 (40.8 %) were IUD and 42 (59.1 %) were live born. On analyzing the morbidity data, it was found that HEV-positive women (deranged coagulogram 71.05 %, IUD 75.86 %, encephalopathy 80 %) had a poorer outcome as compared to their HBsAg positive counterparts (deranged coagulogram 10.52 %, IUD 13.79 %, encephalopathy 6.66 %).

Conclusion

Urgent redressal of issues pertaining to sanitation and provision for clean drinking water for citizens of India is the need of the hour as HEV is fecooral in transmission.

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Compliance with ethical statement and Conflict of interest

It was an observational study, and patients were managed according to the routine obstetric and hospital protocol so the ethical committee clearance was not sought. The authors has no conflict of interest.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095, India

    Anshuja Singla (Assistant Professor), Sumita Mehta (Specialist), Shalini Rajaram (Director Professor) & Sneha Shree (Senior Resident)

Authors
  1. Anshuja Singla
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  2. Sumita Mehta
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  3. Shalini Rajaram
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  4. Sneha Shree
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Correspondence to Anshuja Singla.

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Singla, A., Mehta, S., Rajaram, S. et al. Materno-Fetal Outcomes with Viral Hepatitis in Pregnancy. J Obstet Gynecol India 66, 166–169 (2016). https://doi.org/10.1007/s13224-014-0666-5

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  • DOI: https://doi.org/10.1007/s13224-014-0666-5

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