Materno-Fetal Outcomes with Viral Hepatitis in Pregnancy.
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 %).


CONCLUSIONS
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.
Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095 India.
Anshuja
A
Singla
Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095 India.
Sumita
S
Mehta
Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095 India.
Shalini
S
Rajaram
Department of Obstetrics & Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095 India.
Sneha
S
Shree
Coagulopathy; Encephalopathy; Fecooral transmission; Hepatitis B; Hepatitis E; Hepatotrophic viruses; Pregnancy