Fetomaternal Outcome in Acute Viral Hepatitis

Viral hepatitis is one of the commonest causes of jaundice in pregnancy. Hepatitis E viral (HEV) infection is associated with major catastrophes in pregnancy with high maternal and foetal mortality rate.

To determine the prevalence of HEV infection in pregnancy and to study maternal and foetal outcome in acute HEV and non HEV infection.

This was a prospective observational study, conducted at SAIMS obstetrics department over a period of 2 years, June 2011-June 2013, among pregnant women presented with features of acute viral hepatitis like nausea, vomiting, jaundice, fever etc. These women were further investigated and those who were found to be positive for infection with HAV, HBV and HEV were further studied in view of maternal and foetal outcome.

Pregnant women who were found to be suffered from acute viral hepatitis were twenty five. Majority of women were unbooked (90%) with mean age of 23±3.5years, most of them were presented in third trimester with mean gestational age of 31.33±3.5 weeks. Primigravida (58%) forms the largest group. Infective pathology due to HEV was 84% and 16% due to HAV and none of the patients were found to be acutely infected with HBV, HCV. HEV infected patients found to have high rate of complications as compared to non HEV infected patients. HEV infected patients had high rate of abortion (4.7%), fulminant hepatic failure (23.8%), Disseminated intravascular coagulation (33%), acute respiratory distress syndrome (14.28%), hepatic encephalopathy (23.8%), acute renal failure (9.52%), intrauterine foetal demise (35.29%), low birth weight (84.6%), NICU admission rate and preterm labour as compared to non HEV infected patients.

Acute hepatitis E viral infection in pregnancy carries a poor maternal and foetal outcome as compared to other viral hepatitis causative agents.