Hepatitis E in pregnancy.
OBJECTIVE
To study the spectrum and the clinical and biochemical course of viral hepatitis E during pregnancy.


METHODS
In this prospective study, sera of 62 pregnant women having jaundice in the third trimester of pregnancy were analyzed for markers of hepatitis A, B, C and E viruses. The cord blood samples of hepatitis E virus (HEV)-positive pregnant women at the time of delivery were tested for IgM anti-HEV antibodies by enzyme-linked immunosorbent assay and HEV-RNA by reverse transcriptase polymerase chain reaction.


RESULTS
Of the 62 patients, 45.2% had HEV infection and nine developed fulminant hepatic failure (FHF). Eighty-one percent of FHF cases and 37.25% of acute viral hepatitis cases were caused by HEV. Approximately two-thirds of the pregnant women with HEV infection had preterm deliveries. The mortality rate among the HEV-positive pregnant women was 26.9%. Vertical transmission was observed in 33.3% of cases.


CONCLUSIONS
One-third of the pregnant women with HEV infection had a severe form of hepatitis in the third trimester of pregnancy, i.e. FHF. Hepatitis E in pregnancy is associated with high rates of preterm labor and mortality.
Kumar
A
A
Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India. ashkumar@eth.net
Beniwal
M
M
Kar
P
P
Sharma
J B
JB
Murthy
N S
NS
D000328:Adult; D005260:Female; D016751:Hepatitis E / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D015994:Incidence; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D017093:Liver Failure / Q000821:virology; D007752:Obstetric Labor, Premature / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies