Fetomaternal outcome in pregnancy with hepatitis E infection

Authors

  • Preeti F. Lewis Department of Obstetrics and Gynecology, Grant Government Medical College, Mumbai, Maharashtra, India
  • Sampada Prasad Department of Obstetrics and Gynecology, Grant Government Medical College, Mumbai, Maharashtra, India
  • Nitin B. Bavdekar Medical Officer, MMHS , Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205759

Keywords:

Hepatitis E, Pregnancy, Fulminant hepatic failure, Maternal mortality, Still births, Hepatic encephalopathy, Coagulopathy

Abstract

Background: HEV infection, a major public health concern, is known to cause large-scale epidemic and sporadic cases of acute viral hepatitis in developing countries. The infection occurs primarily in young adults and is generally mild and self-limiting; however, the case fatality rate is reportedly higher among pregnant women.

Methods: Our study, a retrospective observational study, was conducted in a tertiary care center for over a period of 3 years (January 2017 to January 2020) to find out the fetal and maternal outcome in pregnant women with HEV infection.

Results: A total of 38 antenatal cases with anti-HEV IgM-positive were included, and the maternal-fetal outcome was analyzed. The maternal mortality was 52.63 % especially during 3rd trimester and post-partum period, including 5 antenatal death. The most common maternal complication was acute fulminant hepatitis (39.5 %), DIC (36.8 %) and hepatic encephalopathy (31.6%). Prematurity (33.3% of total live births) and Still births (32.3 %) including 4 freshes still births were the commonest fetal complications noted.

Conclusions: Our study shows that pregnant woman with acute viral hepatitis due to hepatitis E virus infection had a high mortality rate especially during 3rd trimester and post-partum period with poor obstetric and fetal outcome.

References

Labrique AB, Sikder SS, Krain LJ, West KP, Christian P, Rashid M, et al. Hepatitis E, a vaccine-preventable cause of maternal deaths. Emerg Infect Dis. 2012;18:1401-4.

Purcell RH, Emerson SU. Hepatitis E: an emerging awareness of an old disease. J Hepatol. 2008;48:494-503.

Aggarwall R. Clinical presentation of hepatitis E. Virus Res. 2011;161:15-22.

Renou C, Gobert V, Locher C, Moumen A, Timbely O, Savary J. Prospective study of hepatitis E virus infection among pregnant women in France. Virol J. 2014;11:11-68.

Renou C, Gobert V, Locher C, Moumen A, Timbely O, Savary J. Prospective study of hepatitis E virus infection among pregnant women in France. Virol J. 2014;11:11-68.

Jilani N, Das BC, Husain SA, Baweja UK, Chattopadhya D, Gupta RK, et al. Hepatitis E virus infection and fulminant hepatic failure during pregnancy. J Gastroenterol Hepatol. 2007;22(5):676-82.

Kasper L, Fauci J. Acute viral hepatitis. Harrison’s Princ Intern Med. 2015;2(18):2537-555.

Lindemann ML, Gabilondo G, Romero B, de la Maza OM, Pérez‐Gracia MT. Low prevalence of hepatitis E infection among pregnant women in Madrid, Spain. J Medic Virol. 2010;82(10):1666-8.

Kasper L, Fauci J. Acute viral hepatitis. Harrison’s Princ Intern Med. 2015;2(18):2537-55.

Yadav S, Shirodker S, Kshirsagar S. Maternal and fetal outcome in pregnancy with hepatitis E virus infection. Int J Reprod Contracept Obstet Gynecol 2016;5:3482-90.

Prasad GS, Prasad S, Bhupali A, Patil AN, Parashar K. A study of hepatitis E in pregnancy: Maternal and fetal outcome. J Obstet Gynecol Ind. 2016;66(1):18-23.

Singh S, Mohanty A, Joshi YK, Dwivedi SN, Deka D. Outcome of hepatitis E virus infection in Indian pregnant women admitted to a tertiary care hospital. Ind J Med Res. 2001;113:35-9.

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Published

2020-12-26

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Section

Original Research Articles