scholarly journals Pregnancy Outcome in Viral Hepatitis

2013 ◽  
Vol 5 (2) ◽  
pp. 60-63
Author(s):  
Sulbha Joshi ◽  
Varsha Kose
Keyword(s):  
Viral Hepatitis ◽  
Pregnancy Outcome ◽  
Hepatitis E ◽  
Fetal Outcome ◽  
Research Centre ◽  
Premature Delivery ◽  
Fetal Mortality ◽  
Obstetrics And Gynecology ◽  
Major Public Health Problem ◽  
In Pregnancy

ABSTRACT Introduction Hepatitis in pregnancy is an important medical disorder seen more often in developing countries than in developed ones. Viral hepatitis is a major public health problem in India. Hepatitis in pregnancy is commonly associated with abortion, premature delivery, postpartum hemorrhage, coagulation defect, obstetric shock, coma, death and increased perinatal mortality and morbidity. This study was carried out to know the effect of viral hepatitis on pregnancy and to study its maternal and fetal outcome. Materials and methods This prospective clinical study was conducted in the Department of Obstetrics and Gynecology NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, from January 2010 to December 2012. All the antenatal cases attended Obstetrics and Gynecology Department were investigated for HBsAg and looked for any symptoms and signs suggesting hepatitis like fever, jaundice, nausea, vomiting. If present, they were admitted and further investigated to detect viral hepatitis. Patients were counseled for follow-up and strict hospital delivery. Patients with viral hepatitis were analyzed for the effect on pregnancy, maternal and fetal outcome. Results There were total 30 cases of viral hepatitis 24 (80%) cases were HBsAg positive, but all were asymptomatic 6 (20%) cases were hepatitis E positive. No HAV, HCV, HDV and hepatitis G infected cases were detected in our study. Maternal and fetal morbidity was significantly higher in hepatitis E infected women. Fetal mortality was observed in one case. Conclusion Pregnancy with viral hepatitis requires early diagnosis, hospitalization and treatment. In the present study hepatitis E was found to be the chief etiological agent associated with increased maternal morbidity, and high fetal morbidity and mortality. How to cite this article Kose V, Joshi S. Pregnancy Outcome in Viral Hepatitis. J South Asian Feder Obst Gynae 2013;5(2): 60-63.

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 Doppler ultrasound of umbilical artery in prediction of fetal outcome in pregnancy induced hypertension Sudanese population

2019 ◽  
Vol 8 (1) ◽  
pp. 96
Author(s):  
Rihab A. Yousif ◽  
Awadia G. Suliman ◽  
Raga A. Aburaida ◽  
Ibrahim M. Daoud ◽  
Naglaa E. Mohammed
Keyword(s):  
Flow Velocity ◽  
Umbilical Artery ◽  
Fetal Outcome ◽  
Fetal Mortality ◽  
Pregnancy Induced Hypertension ◽  
Diastolic Flow ◽  
Induced Hypertension ◽  
The Mean ◽  
Doppler Indices ◽  
In Pregnancy

The pregnancy induced hypertension increase the fetal mortality and morbidity and the using of Doppler umbilical artery indices decrease the fetal mortality and morbidity however, there is few complete data about the most frequently altered Doppler US parameters to predict fetal outcome in pregnancy induced hypertension . Methods This ia cohort prospective study done in two hundred and six women of second and third trimester presenting to antenatal clinic in Soba University Hospital at the department of Obstetrics & Gynecology, in the fetus unit and critical pregnancy in the period From June 2008 to April 2013 to assess the Doppler indices of umbilical artery in pregnancy induced hypertension for prediction of prenatal outcome; 105 pregnancy induced hypertension patients and 101 women with uneventful pregnancies as normal control group included in this study . Baseline investigations and color Doppler of umbilical artery were done. Statistical analysis of data were done using SPSS, Receiver Operating Characteristic (ROC) curve analysis was performed and the area under the curve (AUC) used to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of umbilical artery Doppler indices to predict fetal outcome.Results The study determine that there was significant difference in Doppler indices in PIH and control group ( p<0.01, the mean indices of umbilical artery is higher in PIH group compared with normal pregnancy group , the mean different of S/D ratio was 0.40, mean difference of RI was 0.06 and the mean different of PI index was 0.16, high percentage of adverse fetal outcome had been reported in in Pregnancy Induced Hypertension group than in control , which was more in absent and reversed flow velocity in umbilical artery in Pregnancy Induced Hypertension compared with group of Pregnancy Induced Hypertension with present end diastolic flow velocity. Systolic/Diastolic ratio was most accurate in predicting adverse outcome in pregnancy induced hypertension patients, followed by the Pulastility index then the Resistance index (75%, 66% and 57% respectively).ConclusionThis study concluded that pregnancy induced hypertension leads to worsen placental insufficiently, which appears on the higher Doppler indices of umbilical artery to PIH patients when compared with normal pregnancy. A low diastolic flow and higher indices characterized the pregnancies with abnormal outcomes. Doppler of the umbilical artery was useful to predict fetal well being in PIH patients, high percentage of adverse fetal outcome had been reported in absent and reversed end diastolic flow velocity in umbilical artery compared with group of present flow velocity.

scholarly journals An observational study of maternal and fetal outcome in pregnant women with Hepatitis E

2019 ◽  
Vol 8 (8) ◽  
pp. 3110
Author(s):  
Ranjana Mishra ◽  
Arun H. Nayak ◽  
Madhuri Mehendale
Keyword(s):  
Hepatic Encephalopathy ◽  
Pregnant Women ◽  
Hepatitis E Virus ◽  
Mode Of Delivery ◽  
Research Work ◽  
Hepatitis E ◽  
Fetal Outcome ◽  
Medical Complication ◽  
Neonatal Deaths ◽  
In Pregnancy

Background: Hepatitis E in pregnancy has been a subject of interest in the recent years as the available research work is very limited and conflicting especially in pregnant women as compared to infection in men and non- pregnant women in which the disease is usually self- limiting. The mechanism of liver injury in hepatitis E is not clear and no conclusive theories about the exact pathogenesis are available. This study was done to gain insight into the effects of hepatitis E virus on pregnancy in terms of maternal and fetal outcome.Methods: Total of 40 pregnant women with Hepatitis E Virus IgM antibodies was included in the study. Hepatitis cases due to other viral and non-infective causes were excluded. Maternal outcomes in terms of mode of delivery, complications like PPH, hepatic encephalopathy, fulminant hepatic failure, coagulopathy and maternal mortality was studied. Fetal outcomes in terms of intrauterine fetal deaths, stillbirth, live births, and neonatal deaths were studied.Results: This study showed high mortality rates (42.5%) in pregnant women with hepatitis E. The most common obstetric complication was IUFD (45%) followed by preterm labor (32.5%) and postpartum hemorrhage (22.5%). Hepatic encephalopathy (62.5%) was the commonest medical complication followed by coagulopathy (25%). A statistically significant association was found between the presence of medical complications and poor maternal outcome.Conclusions: Hepatitis E virus infection in pregnancy often has a fulminant course with poor maternal and fetal outcome. Its management therefore requires an early diagnosis, and a multidisciplinary approach.

scholarly journals Hepatitis E associated fulminant hepatic failure and its outcome in pregnancy.

2020 ◽  
Vol 27 (10) ◽  
pp. 2165-2169
Author(s):  
Zahida Parveen Brohi ◽  
Uzma Parveen ◽  
Aneela Sadaf
Keyword(s):  
Fulminant Hepatic Failure ◽  
Hepatic Failure ◽  
First Trimester ◽  
Hepatitis E ◽  
University Hospital ◽  
Fetal Mortality ◽  
Clinical Issue ◽  
Viral Marker ◽  
Study Results ◽  
In Pregnancy

Objectives: To determine the clinical features and outcome of hepatitis E associated fulminant hepatic failure in pregnancy. Study Design: Observational Retrospective study. Setting: Department of Obstetrics & Gynecology at Isra University Hospital Hyderabad. Period: Three years from 1st January 2015 to 31st December 2017. Material & Methods: Total 3596 obstetric patients were admitted whom 168 pregnant women who were positive for hepatitis E viral marker have been included in the study. Results: Their age was between 18 to 47 years with mean age 26.04±6.40 years; majority of patients had not received antenatal care 123 (73.2%). Out of 168, 27 (16%) presented in the first trimester, 45 (26.7%) presented in the second trimester, while 96 (57.1%) patients developed fulminant hepatic failure in their 3rd trimester of pregnancy. Out of 168, 111(66%) patients delivered and 57 (33.9%) were undelivered. Fetal and perinatal outcome of delivered patients showed miscarriage 45 (40.5%), stillborn 25(14.8%), preterm delivery 17(15.3%), neonatal death 7 (6.3%) and 17 (15.3%) new born remained alive. Overall maternal mortality was 51 (30.3%). Conclusion: Hepatitis – E related fulminant hepatic failure in pregnancy is a troublesome clinical issue and connected with exceptionally high maternal and fetal mortality. Appropriate diagnosis, early timely intervention can considerably diminish the morbidity and mortality associated with (HEV) Fulminant hepatic failure. 

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.

A PROSPECTIVE STUDY OF MATERNAL AND FETAL OUTCOME OF VIRAL HEPATITIS IN PREGNANCY.

2017 ◽  
Vol 5 (9) ◽  
pp. 70-75
Author(s):  
Madhuri Patil ◽  
◽  
Priyanka Jain ◽  
Alka Patankar ◽  
◽  
...  
Keyword(s):  
Prospective Study ◽  
Viral Hepatitis ◽  
Fetal Outcome ◽  
A Prospective Study ◽  
In Pregnancy

scholarly journals ENDOCRINOLOGY IN PREGNANCY: Pheochromocytoma in pregnancy: case series and review of literature

2017 ◽  
Vol 177 (2) ◽  
pp. R49-R58 ◽  
Author(s):  
K van der Weerd ◽  
C van Noord ◽  
M Loeve ◽  
M F C M Knapen ◽  
W Visser ◽  
...  
Keyword(s):  
Early Recognition ◽  
Case Series ◽  
Fetal Outcome ◽  
Fetal Mortality ◽  
Tertiary Referral Hospital ◽  
Common Causes ◽  
Alpha Blockade ◽  
Receptor Blockers ◽  
Dedicated Team ◽  
In Pregnancy

Pheochromocytoma in pregnancy is extremely rare. Early recognition is crucial as antepartum diagnosis can largely decrease maternal and fetal mortality rates. As symptoms of pheochromocytoma are rather similar to those of other far more common causes of hypertension during pregnancy, timely diagnosis is a challenge. In pregnant patients, similar to non-pregnant patients, increased plasma and/or 24-h urine (nor)metanephrine concentrations most reliably confirm the diagnosis of pheochromocytoma. MRI and ultrasound are the only imaging modalities that can be used safely during pregnancy to localize the tumor. During pregnancy, pretreatment consists of alpha blockade as usual. However, dosing of α-adrenergic receptor blockers during pregnancy is a challenge as hypertension must be treated while preserving adequate uteroplacental circulation. When the diagnosis is made within the first 24 weeks of pregnancy, it is generally recommended to remove the tumor in the second trimester, while resection is generally postponed till after delivery when the diagnosis is made in the third trimester and medical pretreatment is sufficient. Both during and after pregnancy, laparoscopic surgery is the preferred approach for resection of the tumor. There is no consensus in literature about the preferred route and timing of delivery. Therefore, in our opinion, decisions should be made on an individual basis by an experienced and dedicated multidisciplinary team. Over the last decades, maternal and fetal prognosis has improved considerably. Further increasing awareness of this rare diagnosis and treatment of these patients by a dedicated team in a tertiary referral hospital are critical factors for optimal maternal and fetal outcome.

scholarly journals Maternal and fetal outcome in pregnancy with hepatitis E virus infection

2016 ◽  
pp. 3482-3490
Author(s):  
Sunil Yadav ◽  
Sneha Shirodker ◽  
Swapnali Kshirsagar
Keyword(s):  
Virus Infection ◽  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Fetal Outcome ◽  
In Pregnancy

scholarly journals The Effect of Lupus Nephritis on Pregnancy Outcome and Fetal and Maternal Complications

2010 ◽  
Vol 37 (4) ◽  
pp. 754-758 ◽  
Author(s):  
DAFNA D. GLADMAN ◽  
ANU TANDON ◽  
DOMINIQUE IBAÑEZ ◽  
MURRAY B. UROWITZ
Keyword(s):  
Lupus Nephritis ◽  
Renal Disease ◽  
Pregnancy Outcome ◽  
Repeated Measures ◽  
Fetal Outcome ◽  
Pregnancy Induced Hypertension ◽  
Maternal Complications ◽  
Induced Hypertension ◽  
Fetal Complications ◽  
In Pregnancy

Objective.To evaluate the effect of lupus nephritis on pregnancy with respect to fetal outcome, maternal complications, and lupus activity.Methods.All pregnancies seen between 1970 and 2003 in the Lupus Clinic were evaluated for the 3 outcomes. Renal disease was defined as the presence of nephrotic syndrome, dialysis, renal transplant, serum creatinine > 120 mmol/l, proteinuria, sterile hematuria and pyuria, or the presence of casts. Fetal complications were evaluated in pregnancies resulting in either live births or stillbirths. Generalized estimating equations were used to test for differences in outcomes between pregnancies with and without the presence of active renal disease. Repeated measures adjustments were made in the model for multiple pregnancies in the same mother.Results.There were 193 pregnancies in 104 women. Of these, 81 occurred in the presence of active renal disease during the study period, defined as 6 months prior to conception until the date of pregnancy outcome. One hundred twelve pregnancies were defined as nonrenal. No statistical difference was found in pregnancy outcome. Fetal complications were not different between the 2 groups with the exception of low birth weight and congenital malformations, which were observed more frequently in the renal group. Pregnancy-induced hypertension was more frequent in pregnancies with renal disease. Lupus flares were also more likely to occur in pregnancies with renal disease compared to those without.Conclusion.Lupus nephritis in pregnancy does not lead to worsened pregnancy or fetal outcomes. Active renal disease, however, is associated with pregnancy-induced hypertension, as well as a flare of lupus activity during pregnancy.

scholarly journals Effect of viral hepatitis E on maternal and fetal outcome

2017 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Naushaba Rizwan ◽  
Syed Uddin
Keyword(s):  
Viral Hepatitis ◽  
Hepatitis E ◽  
Fetal Outcome
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