Fetomaternal outcome in acute hepatitis e.

OBJECTIVE To determine fetomaternal outcome in pregnant women with acute hepatitis E in terms of pregnancy outcome and perinatal mortality. STUDY DESIGN Case series. PLACE AND DURATION OF STUDY Department of Obstetrics and Gynecology, Sir Ganga Ram Hospital, Lahore, from July 2012 to March 2013. METHODOLOGY Serum samples of 38 patients who presented with jaundice in pregnancy were collected to detect hepatitis E IgM antibodies. Demographics, pregnancy outcome and perinatal mortality was noted in hepatitis E positive cases with cause of complications. Cases with jaundice due solely to any other cause were excluded. RESULTS Twenty five patients had acute hepatitis E with coexistent acute hepatitis A in 1(4%) patient. Their mean age was 25 years and mean gravidity was 2. Among them, 10 (40%) patients were primigravida followed by gravida two in 7 (28%) cases. Twenty four (96%) patients presented in third trimester of pregnancy and in 1 (4%) pregnancy ended in second trimester missed miscarriage. The mean gestational age was 32 weeks. Twenty one (84%) babies were born alive, among them 18 (86%) were preterm. Perinatal mortality was 26%; contributed by intrauterine deaths and early neonatal deaths in 3 (14%) cases each. Total maternal deaths were 5 (20%), 4 (80%) in postpartum period and 1 (20%) in antepartum period due to fulminant hepatic failure in all cases. CONCLUSION Prematurity in newborns and fulminant hepatic failure in mothers are major cause of poor fetomaternal outcome in acute hepatitis E in pregnancy.