scholarly journals A study of fetomaternal outcome of hepatic disorders in pregnancy

2019 ◽  
Vol 8 (3) ◽  
pp. 1182
Author(s):  
Mahima Jain ◽  
Himani Thaker
Keyword(s):  
Maternal Mortality ◽  
Viral Hepatitis ◽  
Rural Areas ◽  
Acute Viral Hepatitis ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Fetal Outcome ◽  
The Body ◽  
Mortality And Morbidity ◽  
In Pregnancy

Background: Liver is a vital organ to maintain physiology of the body and supports every organ of the body. Its proper functioning during pregnancy is essential for a good maternal and fetal outcome. The study analyses the causes and fetomaternal outcome in pregnancies with jaundice and suggests measures to reduce morbidity and mortality.Methods: This is a one-year prospective study in a tertiary care institute during which 7165 deliveries are conducted. Total 55 cases of Jaundice with pregnancy are identified and studied for clinical, biochemical profile, etiology and maternal and fetal outcome. 8 maternal deaths are reported amongst this study group.Results: In this study 55 cases of hepatic disorders in pregnancy are studied. The age group reported is 21-29 years. Majority 72% cases belong to rural areas and 85% in lower socioeconomic class. 96.3% patients were in the third trimester of pregnancy. Most common etiology of hepatic disorders in pregnancy is acute viral hepatitis followed by intrahepatic cholestasis of  pregnancy and preeclampsia and HELLP syndrome. In acute viral hepatitis 81% patients were hepatitis E positive. Most common complication are DIC followed by hemorrhagic shock and subsequently AKI and septicemia. 77.7% babies were born alive and 30.9% NICU admission due to severe birth asphyxia and prematurity. Of these 16.6% died in neonatal period. Maternal mortality in 14.5% patients due to viral hepatits, HELLP and septicemia.Conclusions: Jaundice in pregnancy is a rare medical disorder and deadly combination affecting maternal and fetal outcome. Earl detection and timely intervention with multidisciplinary approach including obstetrician, neonatologist, intensivist and skilled nursing care can help to reduce maternal mortality and morbidity.

scholarly journals Evaluation of maternal and fetal outcome in pregnancies complicated by jaundice-an observational study

2021 ◽  
Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani
Keyword(s):  
Mortality Rate ◽  
Observational Study ◽  
Maternal Mortality ◽  
Viral Hepatitis ◽  
Hellp Syndrome ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Fetal Mortality ◽  
Maternal Mortality Rate ◽  
In Pregnancy

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.

scholarly journals Fetomaternal outcome in pregnancy with hepatitis E infection

2020 ◽  
Vol 10 (1) ◽  
pp. 145
Author(s):  
Preeti F. Lewis ◽  
Sampada Prasad ◽  
Nitin B. Bavdekar
Keyword(s):  
Viral Hepatitis ◽  
Acute Viral Hepatitis ◽  
Post Partum ◽  
Tertiary Care ◽  
Case Fatality ◽  
Hepatitis E ◽  
Fetal Outcome ◽  
Health Concern ◽  
Still Births ◽  
Post Partum Period

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.

Fetomaternal outcome and raised bilirubin level in pregnancy

2017 ◽  
Vol 6 (2) ◽  
pp. 710
Author(s):  
Ruchi Joshi ◽  
Nilesh Dalal
Keyword(s):  
Maternal Mortality ◽  
Pregnant Women ◽  
Bilirubin Level ◽  
Rural Areas ◽  
Serum Bilirubin ◽  
Kidney Injury ◽  
Fetal Outcome ◽  
Serum Bilirubin Level ◽  
In Pregnancy

Background: Jaundice in pregnancy has potentially serious consequences for maternal and fetal health. The cardinal features of hepatobiliary disease may include jaundice, pruritus, abdominal pain; nausea, vomiting, and a variety of liver biochemical test abnormalitiesChallenges involve making the diagnosis and the methods of treatment and their safety for both the mother and the baby.Methods: Based on inclusion criteria, 120 pregnant women were selected from Department of Obstetrics & Gynecology, MGMMC and MYH Indore from 1Aug 2014 to 1st August 2015.Patients were categorized according to serum bilirubin level. Basic investigations done and associated complications studied and correlated according to the severity and degree of jaundice.Results: 60% of the patients were aged between 20 and 30 years. 54% were primigravida. 83.3% lived in rural areas while 74.27% came in emergency. Maternal mortality was found highest in the third trimester and when the serum bilirubin crossed 5mg/dl. 43.34% patients with jaundice developed acute kidney injury with serum creatinine level above the cut-off. INR was deranged in 47.5% of the patients. The most common complication seen in our study group was that of HELLP closely followed by multi organ dysfunction and encephalopathy. 67% of the patients delivered vaginally, while 20% went under LSCS. Maternal mortality was 32.5% and perinatal outcome was poor with 50% mortality and 25% nursery admission. 62% of the patients who died were referred from a peripheral health centre.Conclusions: Liver disease can cause significant morbidity and mortality in both pregnant women and their infants. Better identification and treatment of mothers and fetuses at risk may have far-reaching implications for maternal and child health. Monitored intensive care gives a long term pay off in the maternal and fetal outcome.

scholarly journals Evaluation of Maternal and Perinatal Outcome in Pregnancy with Jaundice in a Tertiary Care Hospital

2021 ◽  
Vol 10 (36) ◽  
pp. 3099-3102
Author(s):  
Mihir Kumar Sarkar ◽  
Arindam Halder
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Viral Hepatitis ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Birth Asphyxia ◽  
Intrauterine Fetal Death ◽  
Care Hospital ◽  
In Pregnancy

BACKGROUND Jaundice in pregnancy contributes to a significant proportion of maternal and perinatal morbidity and mortality in our country. Overall incidence in India is 1 - 4 per 1000 deliveries. There are increased risks of preterm labour, low birth weight babies, meconium-stained liquor, intrauterine fetal death and postpartum haemorrhage. The purpose of this study was to assess the fetomaternal outcome in pregnancy with jaundice in a tertiary level hospital. METHODS This was a two-year retrospective observational study conducted by reviewing the records of jaundice in pregnancy from April 2018 to March 2020. RESULTS Viral hepatitis comes out as the most common cause accounting for 70.37 % of the cases, whereas intrahepatic cholestasis with an incidence of 20. 37 % comes out as the second aetiology. Post-partum haemorrhage is depicted as the major maternal complication whereas prematurity and birth asphyxia come out as the major perinatal complications. CONCLUSIONS The present study projects viral hepatitis (Hepatitis A and E) as the major cause of jaundice in pregnancy. Although low maternal mortality has been recorded in the present study, a high perinatal mortality due to low birth weight and birth asphyxia remains to be a matter of major concern. KEY WORDS Jaundice in Pregnancy, Viral Hepatitis, Postpartum Haemorrhage, Prematurity, Birth Asphyxia

scholarly journals Jaundice in Pregnancy: A Clinical Study at Fatima Memorial System

2015 ◽  
Vol 7 (1) ◽  
pp. 22-25
Author(s):  
Afshaan Ambreen ◽  
Farhatulain Ahmed ◽  
Attia Sheikh ◽  
Muhammad Rashid Ayub ◽  
Numeera Faryad ◽  
...  
Keyword(s):  
Clinical Study ◽  
Viral Hepatitis ◽  
Perinatal Mortality ◽  
South Asian ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Younger Age ◽  
In Pregnancy

ABSTRACT Objective The objective of the study is to find the effect of jaundice during pregnancy on fetomaternal outcome over a 10-year period at tertiary care hospital. Materials and methods An analysis of fetomaternal outcome of all case records with jaundice in pregnancy from January 2003 to December 2013 is made. Results The incidence of jaundice in our study is one in 278 pregnancies, with the disease more common in younger age group. Viral hepatitis found to be the commonest cause, HEV being the commonest with a high maternal and perinatal mortality. Obstetric cholestasis being the second most common followed by HELLP syndrome, AFLP and sepsis; Hepatorenal failure, encephalopathy, DIC and PPH were the main causes of maternal mortality. Conclusion Viral hepatitis is most prevalent cause of jaundice in pregnancy, associated with a high maternal and perinatal mortality and morbidity. How to cite this article Ambreen A, Ahmed F, Sheikh A, Ayub MR, Faryad N, Mushtaq S. Jaundice in Pregnancy: A Clinical Study at Fatima Memorial System. J South Asian Feder Obst Gynae 2015;7(1):22-25.

scholarly journals Fetomaternal outcome in severe preeclampsia and eclampsia: a retrospective study in a tertiary care centre

2017 ◽  
Vol 6 (9) ◽  
pp. 3937
Author(s):  
Shobha Sreedharan Pillai
Keyword(s):  
Retrospective Study ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Liver Function Tests ◽  
Fetal Outcome ◽  
Severe Preeclampsia ◽  
Near Miss ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. In India, they account for the third most important cause of maternal mortality. The objectives of this study were to evaluate maternal and perinatal outcome and complications in cases with severe preeclampsia and eclampsia.Methods: A retrospective study was carried out on 110 women with severe preeclampsia and eclampsia in a tertiary care referral centre over a period of 15 months. Only those cases with initial B.P reading of ≥160/110 mm Hg or presenting with eclampsia were included in the study. Investigations and management were carried out as per standardized department protocol and maternal and fetal outcomes were analyzed.Results: 42% of the cases were in the age group of 26-30 years, nearly 61% were primigravidae and the majority (64) were referred from peripheral hospitals. Liver function tests were deranged in 19% of the patients and 17% had abnormal renal function. Nifedipine was the most commonly used antihypertensive and magnesium sulphate was the anticonvulsant used in all the cases.  Lower segment caesarean section was the mode of delivery in 64.5% of the cases. Commonest maternal complication was atonic PPH. There was no maternal mortality but there were 3 maternal near-miss cases due to DIC. 65% of the cases had a preterm delivery and 39% of the babies needed NICU admission. There were 10 neonatal deaths.Conclusions: Accessible health care and health education and awareness regarding antenatal check-ups for all women will lead to early detection of severe preeclampsia.  Prompt treatment and management of its complications will certainly improve the maternal and fetal outcome. 

scholarly journals Fever in pregnancy and its maternal and fetal outcome at tertiary care level

2018 ◽  
Vol 7 (5) ◽  
pp. 1864
Author(s):  
M. Poovathi ◽  
N. Prasanna
Keyword(s):  
Maternal Mortality ◽  
Dengue Fever ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Pregnant Mother ◽  
Care Level ◽  
Common Cause ◽  
Mortality And Morbidity ◽  
Nicu Admission

Background: The fever during pregnancy is the omnious sign. Early detection and prompt management of fever prevents maternal mortality and morbidity. Any maternal hyperthermia (>38.9°C) potentially affect the fetus. Hence study was conducted to know the outcome of fever in pregnancy.Methods: To study the outcome of pregnant women admitted with fever in obstetrics ward at MGMGH, Trichy over the period of 6 months from July 2017 to December 2017.Results: The incidence of fever was 6%. In this study the most common cause was viral fever among which dengue fever was most common. Hence outcome depends on its impact on pregnant mother and fetus. Many preterm labour (24%) were noted in this study which needs NICU admission of babies. Maternal mortality was 25%, most of it were associated with DIC, IUD and one or two combined risk factors.Conclusions: The incidence of fever was 6%. In this study the most common cause was viral fever among which dengue fever was most common. Hence outcome depends on its impact on pregnant mother and fetus. Many preterm labour (24%) were noted in this study which needs NICU admission of babies. Maternal mortality was 25%, most of it were associated with DIC, IUD and one or two combined risk factors.

scholarly journals Observational study of maternal and fetal outcome in obstetric emergencies admitted to tertiary care centre

2021 ◽  
Author(s):  
Neelima Singh ◽  
Sreedevi . ◽  
Sushma .
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Fetal Outcome ◽  
Tertiary Care Centre ◽  
Cervical Injury ◽  
Mortality And Morbidity ◽  
Obstetric Emergencies

Background: Objectives of the current study were to evaluate the risks factors, clinical presentations, the management and maternal and fetal outcome of common obstetric emergencies encountered at Government general hospital Nizamabad, Telangana, from April 2019 to November 2019.Methods: It is an Observational, hospital-based study done department of obstetrics and gynaecology in 160 cases of obstetric emergencies managed in 8 months study period were reviewed.Results: Out of 3000 deliveries there were 160 cases of obstetric emergencies giving a percentage of 5.33%. About 84% had antenatal care and 16% had not taken ANC with perinatal mortality of 91.9% in booked cases. Out of 160 cases of obstetric emergencies, obstetric haemorrhage constituted 94 (58.75%) cases and among those cases, 23 cases (24.5%) were PPH including both atonic and traumatic, abruptio placenta constituted 35 cases (37.3%). Out of 160 cases of obstetric emergencies, obstructed labour constituted 29 cases (18.1%) being a frequent indication for emergency caesarean section, 1 case of septic abortion and 30 cases eclampsia. 29 perinatal deaths giving the perinatal mortality rate as 181 per 1000 live births. One maternal mortality due to rupture uterus. Maternal morbidity was in the form of wound infections which was found in 6 cases (3.75%), wound gaping in 2 cases (1.25%) PPH in 19 cases (11.81%), septicaemia in 17 cases (10.6%), puerperal pyrexia 6 cases (3.7%), vaginal or cervical injury 6 cases (3.7%), ICU admissions in 9 cases (5.6%). This morbidity increased the number of days of hospital stay to the patients.Conclusions: In majority of cases, the complications are preventable and treatable with proper antenatal and intranatal care. Identification of high risks cases, education of people about the importance of supervised pregnancy, delivery and emergency obstetric care will reduce the maternal mortality and morbidity and perinatal mortality and morbidity significantly.

scholarly journals Thrombocytopenia due to monsoon related illness: as an underestimated cause of maternal mortality and morbidity

2020 ◽  
Vol 8 (3) ◽  
pp. 1001
Author(s):  
Pallavi Amol Kharat ◽  
Shital Borkar ◽  
Naina Dalvi
Keyword(s):  
Platelet Count ◽  
Maternal Mortality ◽  
Viral Infections ◽  
Monsoon Season ◽  
Fetal Outcome ◽  
Monsoon Period ◽  
Mortality And Morbidity ◽  
Blood Disorder ◽  
History Of ◽  
In Pregnancy

Background: Thrombocytopenia is a second leading cause of blood disorder in pregnancy after anaemia. It is defined as platelet count below 1,50,000/ul. It is a common condition occurring in approximately 7-10% of pregnancies. Gestational thrombocytopenia is physiological and occurs in 70-80% of population having platelet count of 1,30,000/ul-1,50,000/ul with no adverse consequences. Other causes of thrombocytopenia in pregnancy could be immune related like immune thrombocytopenia, thrombotic thrombocytopenia or pregnancy related disorders like hypertensive disorders, eclampsia, HELLP and fatty liver of pregnancy. Besides this, pregnant ladies can have thrombocytopenia associated with fever which is commonly observed in monsoon season. It could be because of various causes like dengue, malaria, leptospirosis or other viral infections. Thrombocytopenia carries a risk of haemorrhage for both mother as well as newborn. It carries a risk of vertical transmission leading to premature birth, neonatal thrombocytopenia, intracranial haemorrhage and foetal death. There is relatively less information regarding importance of diversity of infectious diseases on pregnancy outcome.Methods: 14 pregnant patients were studied on the basis of their history of fever, platelet count below 1,50,000/ul and any  history of haemorrhage or petechie during monsoon period from June to September 2019 admitted in gynaecological ward in HBTMC and Dr. R. N. Cooper Hospital, Mumbai. All patients were subjected to fever profile, repeated haemogram for platelet trend and medical reference was done.Results: Out of 14 patients, 9 patients had negative fever profile, 2 were dengue positive, 2 were widal positive and one was leptospira positive patient. All patients had platelet count less than 1,50,000/ul out of which 3 patients received platelet transfusion..Conclusions: Monsoon fever with thrombocytopenia requires early diagnosis and optimal treatment to reduce maternal mortality and to avoid adverse fetal outcome. There is a strong need to create awareness amongst the community.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

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