scholarly journals Hepatitis E viral infection in pregnant ladies, a challenge for obstetricians and physicians

2021 ◽  
Vol 9 (1) ◽  
pp. 54
Author(s):  
Samia Jamil ◽  
Hafiz Muhammad Sajid Jehangir ◽  
Hamza Naeem ◽  
Mahliqa Maqsud ◽  
Mehwish Ayyaz ◽  
...  
Keyword(s):  
Viral Infection ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Post Partum ◽  
Hepatitis E ◽  
Third Trimester ◽  
Spontaneous Vaginal Delivery ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Mean

Background: Hepatitis E Virus (HEV) is the major cause of morbidity and mortality in pregnancy. The virus was detected about three decades ago. The incidence and severity during pregnancy vary widely around the world.Material & Methods: This observational retrospective study was conducted from March 2019 to February 2020 in Obstetrics & Gynecology Department of Lady Aitchison Hospital, Lahore. 70 pregnant women with hepatitis E were subjected to detailed history taking. The diagnosis was based on positive Hepatitis E IgM (Anti HEV IgM) antibody on laboratory test in current pregnancy in antenatal period up to 42 days post partum were included.Results: Out of 70 pregnant women with Hep E IgM+ve, 3 (4.3%) women had Obstetrical hysterectomy as complications, with mean age of 26.0 ± 4.69 years. The mean gestational age when infection occurred was 31.12 ± 5.18 weeks. Among all females 9 (13%) patients expired due to fulminant hepatic failure, 12 (17.14%) females gave birth via spontaneous vaginal delivery (SVD),17(24.2%) females gave birth via C-Section. 30 (42.8%) females were manage conservatively.Conclusion: Hepatitis E viral infection in pregnant females is a life threatening condition. The study showed that pregnant women with jaundice and hepatitis E virus infection had a high mortality rate during third trimester. Early diagnosis and management will help in the control of the disease and prevents its complications.   

scholarly journals Acute Fatty Liver of Pregnancy: A Life Threatening Condition

2020 ◽  
Vol 15 (1) ◽  
pp. 79-80
Author(s):  
Sarita Sitaula ◽  
Ajay Agrawal ◽  
Achala Thakur ◽  
Tara Manandhar ◽  
Babauram Dixit Thapa ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
High Morbidity ◽  
Third Trimester ◽  
Delay In Diagnosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Acute Fatty Liver ◽  
Catastrophic Disease

Acute Fatty Liver of Pregnancy (AFLP) is a rare but catastrophic disease affecting women in pregnancy. It usually occurs in the third trimester or post-partum period. Delay in diagnosis is associated with morbid complications with high morbidity and mortality. We report a case of 24 years old female at 38 weeks period of gestation who presented with jaundice, vomiting for 3 days and deranged liver function test. She was diagnosed as acute fatty liver of pregnancy and was delivered by instrumental delivery but required cesarean hysterectomy due to postpartum hemorrhage. She started improving with supportive care and discharged after 4 weeks of hospital stay. Key words: AFLP, Hysterectomy, Postpartum hemorrhage

Hepatitis E virus genotyping in Pakistan: a regional study to explore the implications for pregnant females

2021 ◽  
Author(s):  
Mahnoor Nadeem ◽  
Tahir Ahmad ◽  
Salik Javed Kakar ◽  
Fazal Adnan ◽  
Sadia Anjum
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Acute Infection ◽  
Hepatitis E ◽  
Immunoglobulin M ◽  
Genotype 1 ◽  
Regional Study ◽  
Third Trimester ◽  
Pregnant Females ◽  
Diagnostic Center

Aim: Hepatitis E virus (HEV) has different genotypes 1–4, which is generally associated with mild to severe complications among immunocompromised patients and pregnant women. Materials & methods: Immunoglobulin M (IgM) HEV-positive samples were collected from the diagnostic center. HEV infection was further confirmed by RT-based PCR and genotyping was done to affirm the prevailing genotype. Results: This study identified 28 patients from Islamabad who were confirmed to have immunoglobulins type M against HEV showing acute infection, of which 17 were pregnant and 11 were non-pregnant women. All pregnant women were in their third trimester of pregnancy. Conclusion: Genotype-1 is commonly associated with pregnant females presenting with HEV infections in Islamabad. There is a need to further identify both the sources & route of infections.

scholarly journals A study on faeto-maternal outcome in pregnancy with jaundice due to hepatitis E

2017 ◽  
Vol 6 (3) ◽  
pp. 861
Author(s):  
Sushanta Kumar Jena ◽  
Minakshi Mohanty ◽  
Sasmita Behuria
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Rna Virus ◽  
Hepatitis E ◽  
Oral Route ◽  
Maternal Outcome ◽  
Third Trimester ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Careful Management

Background: Hepatitis E virus is a non-envelope RNA virus responsible for large epidemics in Asia, the Middle east Mexico and Africa. It spreads via the feco-oral route, and has an incubation period of 8-10 weeks. The objective of the study was to find out the effect of hepatitis E during pregnancy on faeto-maternal outcome.Methods: A study on faeto-maternal outcome of 38 pregnant women admitted with jaundice due to hepatitis E to the Department of Hepatology, Shri Ramachandra Bhanj (SCB) Medical College, Cuttack, Odisha, India during January 2015 to December 2015.Results: 38 Pregnant women admitted to the Department of Hepatology of SCB Medical College, Cuttack, Odisha, India were studied. 65.7% were from rural area, 92.1% were in their third trimester of pregnancy. Serum bilirubin >10 mg in 52.19 %, SGOT, SGPT and alkaline phosphatase were raised in majority of them. Out of 38 women 32 delivered and 6 remain undelivered. In 81.25% of cases labor was spontaneous, perinatal mortality was observed in 46.87% of cases and 5 women died during child birth.Conclusions: When pregnancy is associated with jaundice due to hepatitis E, there is high perinatal and maternal morbidity and mortality. Early diagnosis and careful management is required for such cases.

scholarly journals Advances in Hepatitis E Virus Biology and Pathogenesis

Viruses ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 267
Author(s):  
Shaoli Lin ◽  
Yan-Jin Zhang
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Case Fatality ◽  
Hepatitis E ◽  
Host Cells ◽  
High Rate ◽  
Rapid Progression ◽  
Genotype 1 ◽  
Genotype 3 ◽  
Zoonotic Infections

Hepatitis E virus (HEV) is one of the causative agents for liver inflammation across the world. HEV is a positive-sense single-stranded RNA virus. Human HEV strains mainly belong to four major genotypes in the genus Orthohepevirus A, family Hepeviridae. Among the four genotypes, genotype 1 and 2 are obligate human pathogens, and genotype 3 and 4 cause zoonotic infections. HEV infection with genotype 1 and 2 mainly presents as acute and self-limiting hepatitis in young adults. However, HEV infection of pregnant women with genotype 1 strains can be exacerbated to fulminant hepatitis, resulting in a high rate of case fatality. As pregnant women maintain the balance of maternal-fetal tolerance and effective immunity against invading pathogens, HEV infection with genotype 1 might dysregulate the balance and cause the adverse outcome. Furthermore, HEV infection with genotype 3 can be chronic in immunocompromised patients, with rapid progression, which has been a challenge since it was reported years ago. The virus has a complex interaction with the host cells in downregulating antiviral factors and recruiting elements to generate a conducive environment of replication. The virus-cell interactions at an early stage might determine the consequence of the infection. In this review, advances in HEV virology, viral life cycle, viral interference with the immune response, and the pathogenesis in pregnant women are discussed, and perspectives on these aspects are presented.

scholarly journals Hepatitis E and Pregnancy: An Unholy Alliance Unmasked from Kashmir, India

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1329
Author(s):  
Mohammad Sultan Khuroo
Keyword(s):  
Viral Replication ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Polymerase Activity ◽  
Severe Liver ◽  
Reading Frame ◽  
Multiple Factors ◽  
Severe Liver Disease ◽  
Development And Management

The adverse relationship between viral hepatitis and pregnancy in developing countries had been interpreted as a reflection of retrospectively biased hospital-based data collection by the West. However, the discovery of hepatitis E virus (HEV) as the etiological agent of an epidemic of non-A, non-B hepatitis in Kashmir, and the documenting of the increased incidence and severity of hepatitis E in pregnancy via a house-to-house survey, unmasked this unholy alliance. In the Hepeviridae family, HEV-genotype (gt)1 from genus Orthohepevirus A has a unique open reading frame (ORF)4-encoded protein which enhances viral polymerase activity and viral replication. The epidemics caused by HEV-gt1, but not any other Orthohepevirus A genotype, show an adverse relationship with pregnancy in humans. The pathogenesis of the association is complex and at present not well understood. Possibly multiple factors play a role in causing severe liver disease in the pregnant women including infection and damage to the maternal-fetal interface by HEV-gt1; vertical transmission of HEV to fetus causing severe fetal/neonatal hepatitis; and combined viral and hormone related immune dysfunction of diverse nature in the pregnant women, promoting viral replication. Management is multidisciplinary and needs a close watch for the development and management of acute liver failure. (ALF). Preliminary data suggest beneficial maternal outcomes by early termination of pregnancy in patients with lower grades of encephalopathy.

Pituitary dimensions and volume measurements in pregnancy and post partum

1998 ◽  
Vol 39 (1) ◽  
pp. 64-69 ◽  
Author(s):  
H. Dinç ◽  
F. Esen ◽  
A. Demirci ◽  
A. Sari ◽  
H. Resit Gümele
Keyword(s):  
Pituitary Gland ◽  
Matched Control ◽  
Post Partum ◽  
Three Dimensions ◽  
Maximum Height ◽  
Third Trimester ◽  
Normal Pituitary Gland ◽  
Volume Measurements ◽  
Length Width ◽  
The Mean

Purpose: Our purpose was to clarify and further characterize the changes in height, length, width, volume, and shape in the normal pituitary gland and in width in the infundibulum during pregnancy and the first 6 months post partum. Material and Methods: Cranial MR imaging was performed in 78 women who were pregnant in the second or third trimester or who were post partum, and in 18 age-matched control subjects who were not pregnant. Volume measurements were performed in 2 ways; volume 1=1/2xheightxlengthxwidth; and volume 2=area (measured by trackball)xslice thickness Results: Gland volume, height, width, length, and convexity, and infundibular width increased during pregnancy. the highest values were seen during the 3 days immediately post partum. When compared with volunteers, volumes 1 and 2 showed the largest increase (120%) among the parameters. Gland height showed the best correlation (r=0.94, p>0.00001) with gestational age. the mean height of the gland was 8.76 mm in the third trimester. None of the pregnant women had a gland height of above 10 mm during pregnancy. Only 2 subjects had gland heights of 10.04 and 10.2 mm during the 0–3 days post partum. After this first post-partum period of 3 days, the gland size, shape, and volume and the infundibular width returned to normal within 6 months Conclusion: the pituitary gland enlarges in three dimensions throughout pregnancy. During pregnancy, the volume of the gland shows the highest percentage of increase compared to its length, height, and width. the maximum height of the gland does not exceed 10 mm during pregnancy but it may exceed 10 mm during the 3 days immediately post partum.

scholarly journals INTENSITAS NYERI PINGGANG DAN PINGGUL PADA IBU HAMIL YANG MELAKSANAKAN YOGA PRENATAL DI KOTA DENPASAR

2020 ◽  
Vol 2 (2) ◽  
pp. 69
Author(s):  
Ni Made Dwi Purnamayanti ◽  
Gusti Ayu Eka Utarini
Keyword(s):  
Pregnant Women ◽  
Pain Intensity ◽  
Descriptive Study ◽  
Effective Strategy ◽  
Third Trimester ◽  
Cross Sectional ◽  
Mild Pain ◽  
The Mean ◽  
Observational Descriptive Study

Nyeri pinggang dan panggul merupakan keluhan yang umum dirasakan oleh wanita hamil terutama pada akhir kehamilan. Olah raga termasuk yoga prenatal merupakan strategi yang efektif dan disarankan untuk mengatasi nyeri pinggang dan panggul. Penelitian ini bertujuan untuk mendapatkan gambaran intensitas nyeri pinggang dan panggul pada ibu hamil trimester III yang melaksanakan yoga prenatal di Kota Denpasar. Penelitian ini merupakan penelitian deskriptif observasional dengan pendekatan cross sectional terhadap 96 ibu hamil trimester III yang melaksanakan yoga prenatal di kota Denpasar. Didapatkan hasil rerata intensitas nyeri pinggang dan panggul yang dirasakan adalah 1.88 (SD ±2.202). Sebagian besar responden (41.7%) merasakan nyeri pada area tulang belakang disekitar lumbal hingga diatas sacrum.Intensitas nyeri pinggang dan pelvis pada ibu hamil trimester III di Kota Denpasar yang melaksanakan yoga prenatal tergolong nyeri intensitas ringan.Lumbopelvic pain are common complaints felt by pregnant women. Exercise, including prenatal yoga, is an effective strategy and is recommended for treating pregnancy-related lumbopelvic pain. The purpose of the syudi is to know the intensity of pregnancy-related lumbopelvic painamong woman who performe prenatal yoga in Denpasar. This study was an observational descriptive study with a cross sectional approach. The subjeck study was 96 third trimester pregnant women who performed prenatal yoga in Denpasar. The mean pain intensity was 1.88 (SD ± 2.202). Most respondents (41.7%) felt pain in the spinal area around the lumbar to above the sacrum. The intensity of pregnancy-related lumbopelvic pain among third trimester pregnant women in Denpasar who performe prenatal yoga is mild pain.

scholarly journals Seroprevalence of hepatitis E virus in pregnant women in northern Lebanon

2020 ◽  
Vol 26 (5) ◽  
pp. 580-585
Author(s):  
Mohamad Bashar Ismail ◽  
Safaa Khodor ◽  
Marwan Osman ◽  
Hassan Mallat ◽  
Fouad Dabboussi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Hepatitis E

SEROPREVALENCE OF HEPATITIS E VIRUS (HEV) INFECTION AMONG PREGNANT WOMEN IN SOUTH INDIA

2021 ◽  
pp. 28-31
Author(s):  
Nivedhitha E ◽  
Selvi R ◽  
Kayalvili KK ◽  
Arul selvan S ◽  
Duraivel M
Keyword(s):  
Drinking Water ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
South India ◽  
Educational Status ◽  
Hepatitis E ◽  
Elisa Test ◽  
Public Health Issue ◽  
Water Type ◽  
Mortality And Morbidity

Background: Hepatitis E virus (HEV) infection poses a major public health issue in countries with poor drinking water supply, inadequate rd sanitation and improper disposal of human excretes. It causes fulminant hepatitis in pregnant women during 3 trimester with a high mortality rate of 20-30%. Aim:The aim of the study was to estimate the seroprevalence of HEVinfection among pregnant women in South India. Materials and methods: Atotal of 200 asymptomatic, pregnant women were included in the study was evaluated using a questionnaire form. 5ml of blood samples were collected from them and serum was separated to detect for the presence of HEV-antibodies and HEV-RNA by ELISA test and RT-PCR test respectively. Results: The prevalence of HEV-antibodies was found to be 11.5%. HEV-RNA was not present in any participants. A very high statistical signicance was seen associated with the risk factors such as educational status, source of drinking water, type of toilet system used, and the habit of hand washing after using toilets (P<0.01). Conclusion: Even though the prevalence of HEV among the pregnant women is low, periodic assessment and screening of the pregnant women should be done. Encouraging the public sector to strictly adhere to the personal hygienic measures will denitely have an impact in the maternal as well as perinatal mortality and morbidity

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