DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182873

A prospective study of fetomaternal outcome in patients of pregnancy with jaundice in tertiary care centre

Monica Arora, Suniti Verma, Ranjana Desai, Ram Narain Sehra

Abstract


Background: The objective of the study was to study the incidence of jaundice, biochemical alterations, Fetomaternal outcome and various liver pathologies of pregnant patients with jaundice.

Methods: This was a prospective observational study conducted in Dr S N Medical College Jodhpur, Rajasthan, India from June 2014 to February 2016. Total fifty pregnant patients with clinical jaundice and prodromal symptoms of hepatitis were included in study.

Results: Out of 40,398 deliveries in our hospital, 50 cases of jaundice were identified giving an incidence of 1 in 808 (0.12%). Most common cause of jaundice in pregnancy in our set up was viral hepatitis i.e. 13 cases (26%) were HEV+ and 1 case (2%) came out to be HAV+. Serum LDH levels were raised in 36% of patients. Maximum no. of patients had their serum AST/ALT levels in the range of 100-1000 IU/ml (54%). Out of 52 births (2 twins) 34 were live births (65.38%) and rest were either SB or IUFDs. Most common causes of mortality in patients were Septicemia, MODS, DIC (25%) followed by HELLP syndrome and HEV+ viral hepatitis equally (16.67%). Maximum no. of patients with jaundice suffered from postpartum haemorrage and septicemia (60%).

Conclusions: Most common cause of jaundice in pregnancy in our study was viral hepatitis. Public awareness about the various routs of transmission of different types of infective hepatitis, improving sanitary conditions and habits, health education of preventive measures can help in reducing the burden of jaundice in pregnancy.


Keywords


Fetomaternal outcome, Jaundice, Mortality, Pregnancy

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References


Jain RK. Management of jaundice in pregnancy. Medicine update. 2010;20:470-6

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

Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Rouse DW, Spong CY. Hepatic, gallbladder and pancreatic disorders. Williams Obstetrics. 23rd ed. McGraw Hill, New York; 2010: 1063

Bean WB, Cogswell R, Dexter M. Vascular changes of skin in pregnancy: Vascular spider and palmar erythema. Surg Gynecol Obstet. 1949:88(6):739-52.

Kumar A, Beniwal M, Kar P, Sharma JB, Murthy NS. Hepatitis E in pregnancy. Int. J Gynaecol Obstet. 2004;85(3):240-4

Elinav E, BenDov IZ, Sharpia Y, Daudi N, Alder R, Showel D et al. Acute hepatitis A infection in pregnancy associated with high rates of gestational complications and preterm labour. Gastroenterology. 2006;130(4):1129-34.

Banait VS, Sandur V, Parikh F, Murugesh M, Ranka P, Ramesh VS et al. Outcome of acute liver failure due to acute hepatitis in pregnant women. Indian J Gastroenterol. 2007;26(1):6-10.

Acharya N, Acharya S, Shukla S, Athvale R, Shaveta. Study of jaundice in pregnancy. Global J Med Res Gynecol and Obstet. 2013;13(2):25-9.

Reddy MG, Prabhakar GC, Vijaya Sree. Maternal and fetal outcome in jaundice complicating pregnancy. J NTR Univ Health Sci. 2014;3(4):231-3

Jayati Nath, 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.

Barge N, Ching ling Yi, Dalal AR. Study of jaundice in pregnancy in a tertiary care institute in India. Bombay Hospital J. 2011;53(2):181-3.

Bera SK, Sen Gupta A. A 12 year study of maternal deaths in Eden hospital. J Obstet Gynecol India.2002;42:482-8

Trivedi SS, Goyal U, Gupta U. A study of maternal mortality due to viral hepatitis J Obstet Gynecol India. 2003;55:551-3.

Sapre S, Joshi V. Changing trends of maternal mortality in North Madhya Pradesh. J Obstet Gynecol. 2009;49:53-56.