title: Stable versus progressive hepatitis unique to pregnancy.
abstract: BACKGROUND
  Urgent delivery of the fetus is often considered as the treatment of choice for mothers in their second or third trimester with hepatitis unique to pregnancy (HUP).
  
  
  OBJECTIVE
  To determine whether standard liver function tests (serum bilirubin and international normalized ratio levels) help to identify mothers and their newborns who might benefit from early delivery.
  
  
  METHODS
  A total of 149 patients with HUP were retrospectively classified as those with normal (stable-HUP, n=118) or abnormal (progressive-HUP, n=31) liver function tests. Clinical outcomes consisted of maternal lengths of hospital stay after delivery and neonatal appearance, pulse, grimace, activity, respiration score ratings at 0 and 5 min.
  
  
  RESULTS
  Patients with stable-HUP had similar lengths of hospital stay after delivery whether delivered early (4.8±3.4 days) or at term (4.8±3.6 days). Appearance, pulse, grimace, activity, respiration score ratings at birth were similar in neonates from patients with stable-HUP delivered prematurely (5.8±2.7) and at term (7.8±1.7, P=0.48) but significantly higher at 5 min in those delivered at term (7.5±2.0 vs. 8.9±0.3, P=0.003). Too few patients with progressive-HUP were delivered at term (N=4) to allow similar comparisons in this cohort.
  
  
  CONCLUSIONS
  The results of this study indicate that mothers with HUP and normal liver function tests (bilirubin and international normalized ratio) can be safely followed to term without jeopardizing the health of either mother or neonates. Additional studies are required to determine whether abnormal liver function tests represent an indication for immediate delivery of the fetus in mothers with HUP.
authors.affiliation: Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Vivian
authors.initials: V
authors.lastname: Schutt
authors.forename: Julia
authors.initials: J
authors.lastname: Uhanova
authors.forename: Carol
authors.initials: C
authors.lastname: Schneider
authors.forename: Savas
authors.initials: S
authors.lastname: Menticoglou
authors.forename: Cheryl
authors.initials: C
authors.lastname: Greenberg
authors.forename: Dong Feng
authors.initials: DF
authors.lastname: Sun
authors.forename: Denis
authors.initials: D
authors.lastname: Lehotay
authors.forename: Gerald Y
authors.initials: GY
authors.lastname: Minuk
mesh_terms: D000328:Adult; D001663:Bilirubin / Q000097:blood; D003657:Decision Making; D036861:Delivery, Obstetric; D018450:Disease Progression; D005260:Female; D006505:Hepatitis / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D019934:International Normalized Ratio; D007902:Length of Stay; D008111:Liver Function Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000821:virology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001663:Bilirubin