A prospective study on pregnancy complicated with jaundice with special emphasis on fetomaternal outcome

Neha Choudhary; Sangeeta Sen; Varalakshmi K.

doi:10.18203/2320-1770.ijrcog20175029

Authors

Neha Choudhary Department of Obstetrics and Gynecology, Panna Dhaya Zanana Hospital, RNT Medical College, Udaipur, Rajasthan, India
Sangeeta Sen Department of Obstetrics and Gynecology, Panna Dhaya Zanana Hospital, RNT Medical College, Udaipur, Rajasthan, India
Varalakshmi K. Department of Obstetrics and Gynecology, Panna Dhaya Zanana Hospital, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20175029

Keywords:

Jaundice, Pregnancy with jaundice, Serum bilirubin

Abstract

Background: Jaundice defined as yellow discolouration of skin, sclera and mucus membrane resulting from increased serum bilirubin concentration. It is usually clinical visible when plasma bilirubin exceeds 3mg/dl. This study aimed at determining maternal and foetal outcome in women with jaundice complicating pregnancy.

Methods: This prospective study was conducted on 58 cases of pregnant women with jaundice (serum bilirubin ≥3 mg%) admitted at Panna Dhaya Zanana Hospital (PDZH), RNT Medical College, Udaipur, Rajasthan from January 2016 December 2016.

Results: The incidence observed in this study was 0.28%. 77.59% cases in this study were in third trimester of pregnancy. Serum bilirubin was >20 mg% in 5.18% cases. Haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, acute fatty liver of pregnancy, intrahepatic cholestasis of pregnancy, viral hepatitis and malaria were the causes of jaundice. HELLP syndrome was the most common cause of jaundice. Of 58 women 38 delivered vaginally and 12 were LSCS for obstetrical indication and 8 were undelivered. The disease is associated with high incidence of preterm labour, IUGR, birth asphyxia and foetal distress. Perinatal mortality was 38%. Maternal mortality in 11 cases i.e. 18.96%. Main causes of maternal mortality were hepatic encephalopathy, DIC followed by shock due to PPH, DIC followed by multiple organ dysfunction syndrome.

Conclusion: Jaundice and pregnancy having a grave prognosis, resulting in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management.

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References

Reddy MG, Prabhakar GC, Sree V. Maternal and fetal outcome in jaundice complicating pregnancy. J NTR Univ Health Sci. 2014;3:231-3.

Misra R. Ian Donald’s Practical Obstetric Problems, 7th edition. Lippincott Williams and Wilkins; 2014.

Mitra AK, Patki PS, Mitra SK. Liver disorders during pregnancy and their management. The Antiseptic. 2008;105(4):193-6.

Ch’ng CI, Morgan M, Hainsworth I. Prospective study of liver dysfunction in pregnancy in South West Wales. Gut. 2002;51(6):876-80.

Nagaria T, Agarwal S. Fetomaternal outcome in jaundice during pregnancy. J Obstet Gynecol India. 2005;55(5):424-7.

Acharya N, Acharya S, Shukla S, Athvale R, Shaveta. Study of jaundice in pregnancy. Global J Med Res Gynecol Obstet. 2013;13(2).

ACOG technical bulletin. Hepatitis in pregnancy. Int J OB-GY. 1993;42:189.

Ambreen A, Ahmed F, Sheikh A, Ayub MR, Faryad N, Mushtaq S. Jaundice in pregnancy: a clinical study at Fatima Memorial System. J South Asian Feder Obst Gynae. 2015;7(1):22-5.

Parveen T, Begum F, Akhter N. Feto-maternal outcome of jaundice in pregnancy in a tertiary care hospital. Mymensingh Med J. 2015;24(3):528-36.

Wani S, Kadri SM, Bhat S. Prevalence of acute viral hepatitis in women presenting with jaundice with fetomaternal outcome. Global J Med Pub Health. 2013;2(6):1-5.

Krawczynski K, Aggarwal P, Kamili S. Hepatitis E. Infec Dis Clin North Am. 2000:14(3):669-87.

Karegoudar D, Patel R, Dhital M, Amgain K. A study of liver disorder and its consequences in 999 pregnant women with jaundice in tertiary care center in Belgaum, Karnataka, India. IOSR J Den Med Sci. 2014;13(5):14-8.

Krishnamoorthy J, Murugesan A. Jaundice during pregnancy: maternal and fetal outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5(8):2541-5.

ACG clinical guideline: liver disease and pregnancy. Am J Gastroenterol. 2016;111(2):176.

Reyes H, Simon. Intrahapatic cholestasis in pregnancy, an estrogen related disease. Semin Liver Dis. 1993;13:289.

Simms HF, Duff P. Viral hepatitis in pregnancy Semin Perinatol. 1993;17:384.

Sharma S, Aherwar R, Jawade S. Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2016;5(4):1084-7.

Bera SK, Sen Gupta A. A 12 years study of maternal deaths in Eden hospital. J Obstet Gynecol India 1992;42:182-8.

Jayanti N, Bajpayi G, Sharma R. A clinical study on jaundice in pregnancy with special emphasis on fetomaternal outcome. IOSR J Dent Med Sci. 2015;14(3):116-9.

Mitta P, Rao SV. Fetomaternal outcome in jaundice complicating pregnancy. IOSR J Dent Med Sci. (IOSR-JDMS). 2016;15(10)(VI):72-6.