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 Study of feto-maternal outcome in patients with hepatitis E infection during pregnancy

2022 ◽  
Author(s):  
Dipti M. Shah ◽  
Prakash P. Prajapati ◽  
Munjal J. Pandya ◽  
Nimisha J. Chaudhary ◽  
Gira C. Dabhi
Keyword(s):  
Mortality Rate ◽  
Pregnant Women ◽  
Maternal Morbidity ◽  
Monsoon Season ◽  
Fetal Monitoring ◽  
Hepatitis E ◽  
Maternal Outcome ◽  
Morbidity And Mortality ◽  
Third Trimester ◽  
Maternal Morbidity And Mortality

Background: Hepatitis E is considered as a common cause of high maternal morbidity and mortality particularly in third trimester and also high perinatal morbidity and mortality. Thus, this study is conducted to evaluate the feto-maternal outcome in patients infected with hepatitis E during pregnancy.Methods: It is a retrospective observational study conducted in department of obstetrics and gynecology at L. G. hospital. Fifty pregnant women with clinical hepatitis in third trimester of pregnancy were included in this study and thorough investigation were carried out. Patients were monitored till postpartum period and fetal monitoring data were collected from neonatal ICU.Results: In this study, majority of pregnant patients with hepatitis B were admitted during monsoon season suggests that HEV outbreaks are more common during monsoon months. Majority of the patients (70%) were emergency cases. Majority of these patients (82%) were belonged to lower socio-economic class. Co-infection with HAV was in 2% and with HBV in 4%. S. bilirubin >15 mg/dl in 16% of patients. PT and APTT were raised in 28% of patients. FDP was raised in 70% of patients. 76% were delivered vaginally and 22% were delivered by LSCS. Most common complication in HEV infected pregnant women was disseminated intravascular coagulation (DIC) (26%). Maternal mortality rate is 14%. Out of 50 patients, 88% delivered live baby, out of which 72% needed NICU admission. Perinatal mortality rate was as high as 28%.Conclusions: Hepatitis E infection and pregnancy is a deadly and fatal combination. Specifically, in 3rd trimester of pregnancy, acute hepatitis E has a grave prognosis with high maternal morbidity and mortality. Prevention is the mainstay of controlling HEV especially in developing countries.

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 Awareness about government maternal benefit schemes among pregnant women attending Anganawadi centres in North Karnataka

2021 ◽  
Vol 8 (10) ◽  
pp. 4801
Author(s):  
Kausar Mundargi ◽  
Vandana Hiregoudar
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Third Trimester ◽  
Cross Sectional ◽  
Medical College ◽  
Early Registration ◽  
Care Workers ◽  
Maternal Morbidity And Mortality ◽  
Source Of Information

Background: During pregnancy and child birth women are very much vulnerable to sickness and complications. Maternal morbidity and mortality can be reduced by giving proper preventive and promotive health care specially by promoting early registration, regular antenatal check-ups and institutional deliveries. There is an improvement in care since last decade. Still there is a long way in achieving complete success out of these National programmes.Methods: A cross-sectional study was done in six Anganawadi centres in rural field practice area of medical college for a period of 4 months from 1st June 2017 to 30th September 2017. Universal sampling was adopted to include all registered pregnant women. Informed consent was taken. A pre-designed semi-structured questionnaire was used to collect data. Appropriate descriptive statistics like proportion and percentage were used describe and to draw the inferences.Results: A total of 104 pregnant women were included. Most of them were in the age group of 20 to 30 years 76 (73.1%). More than half were in third trimester 60 (57.7%), seeking antenatal care from both government and private facilities equally. Awareness about various schemes ranged from minimum of 2 (1.9%) for JSSK to maximum of 102 (98.1%) for ICDS. ASHA workers 96 (92.3%) acted as source of information for majority of pregnant women followed by Anganawadi workers 88 (84.6%).Conclusions: Knowledge was adequate but not sufficient across all schemes hence more efforts should be done to overcome this discrepancy. Health care workers like ASHA and Anganawadi worker have put efforts in creating awareness. 

scholarly journals Genetic Variability and Evolution of Hepatitis E Virus

Viruses ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 456 ◽  
Author(s):  
Putu Prathiwi Primadharsini ◽  
Shigeo Nagashima ◽  
Hiroaki Okamoto
Keyword(s):  
Genetic Variability ◽  
Hepatitis E Virus ◽  
Rna Virus ◽  
Hepatitis E ◽  
Oral Route ◽  
Genomic Diversity ◽  
Human Populations ◽  
Genotype Distribution ◽  
Modes Of Transmission ◽  
Recent Classification

Hepatitis E virus (HEV) is a single-stranded positive-sense RNA virus. HEV can cause both acute and chronic hepatitis, with the latter usually occurring in immunocompromised patients. Modes of transmission range from the classic fecal–oral route or zoonotic route, to relatively recently recognized but increasingly common routes, such as via the transfusion of blood products or organ transplantation. Extrahepatic manifestations, such as neurological, kidney and hematological abnormalities, have been documented in some limited cases, typically in patients with immune suppression. HEV has demonstrated extensive genomic diversity and a variety of HEV strains have been identified worldwide from human populations as well as growing numbers of animal species. The genetic variability and constant evolution of HEV contribute to its physiopathogenesis and adaptation to new hosts. This review describes the recent classification of the Hepeviridae family, global genotype distribution, clinical significance of HEV genotype and genomic variability and evolution of HEV.

scholarly journals Hepatitis E virus: a review

2008 ◽  
Vol 52 (No. 9) ◽  
pp. 365-384 ◽  
Author(s):  
P. Vasickova ◽  
I. Psikal ◽  
P. Kralik ◽  
F. Widen ◽  
Z. Hubalek ◽  
...  
Keyword(s):  
Developing Countries ◽  
Hepatitis E Virus ◽  
Rna Virus ◽  
Hepatitis E ◽  
Oral Route ◽  
Human Infection ◽  
Risk Of Infection ◽  
Potential Source ◽  
Increased Risk ◽  
Positive Sense

The hepatitis E virus (HEV), the causative agent of hepatitis E, is a non-enveloped RNA virus. The HEV genome is formed by a non-segmented positive-sense RNA chain. The 3´end of the chain is polyadenylated and the 5´end is structurally characterised by the so called “capping”. According to currently accepted taxonomy, HEV is classified in the genus <i>Hepevirus</i>, the only member of the Hepeviridae family. HE is usually transmitted via the faecal-oral route due to the fact that drinking water or water for industrial purposes is contaminated due to poor sanitation. This spread of HEV has been reported in developing countries of Asia, Africa, South and Central America. However, cases in countries with the sporadic occurrence of HEV have been associated with travelling to countries with an increased risk of infection (developing countries in Asia, Africa and America). HEV infections have subsequently been described in people who have not travelled to endemic countries. Further studies of the HEV suggested other routes of transmission and a zoonotic potential of the virus (pigs and deer as the potential source of human infection).

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 Towards the Improved Accuracy of Hepatitis E Diagnosis in Vulnerable and Target Groups: A Global Perspective on the Current State of Knowledge and the Implications for Practice

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 133
Author(s):  
Jasminka Talapko ◽  
Tomislav Meštrović ◽  
Emina Pustijanac ◽  
Ivana Škrlec
Keyword(s):  
Pregnant Women ◽  
Rna Virus ◽  
Hepatitis E ◽  
Oral Route ◽  
Global Perspective ◽  
Genotype 3 ◽  
Specificity And Sensitivity ◽  
Hygiene Measures ◽  
Endemic Areas ◽  
Improved Accuracy

The hepatitis E virus (HEV) is a positive single-stranded, icosahedral, quasi-enveloped RNA virus in the genus Orthohepevirus of the family Hepeviridae. Orthohepevirus A is the most numerous species of the genus Orthohepevirus and consists of eight different HEV genotypes that can cause infection in humans. HEV is a pathogen transmitted via the fecal–oral route, most commonly by consuming fecally contaminated water. A particular danger is the HEV-1 genotype, which poses a very high risk of vertical transmission from the mother to the fetus. Several outbreaks caused by this genotype have been reported, resulting in many premature births, abortions, and also neonatal and maternal deaths. Genotype 3 is more prevalent in Europe; however, due to the openness of the market, i.e., trade-in animals which represent a natural reservoir of HEV (such as pigs), there is a possibility of spreading HEV infections outside endemic areas. This problem is indeed global and requires increased hygiene measures in endemic areas, which entails special care for pregnant women in both endemic and non-endemic regions. As already highlighted, pregnant women could have significant health consequences due to the untimely diagnosis of HEV infection; hence, this is a population that should be targeted with a specific combination of testing approaches to ensure optimal specificity and sensitivity. Until we advance from predominantly supportive treatment in pregnancy and appraise the safety and efficacy of a HEV vaccine in this population, such screening approaches represent the mainstay of our public health endeavors.

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.

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