Study of maternal and prenatal outcome in pregnant women with acute hepatitis E viral infection

Authors

  • Sunita Mishra Department of Obstetrics and Gynaecology, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
  • Rajesh Kumar Jha Department of Medicine, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
  • Ratna Thakur Department of Obstetrics and Gynaecology, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India
  • Sindhuja Tiwari Department of Obstetrics and Gynaecology, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20162115

Keywords:

Pregnancy, Hepatitis E, Central India

Abstract

Background: Hepatitis E Virus (HEV) is a major aspect of hepatitis and death in the developing countries and asymmetrical source of deaths in among of pregnant women. The objective of this study was to determine the maternal and prenatal outcome in pregnant women with acute hepatitis E viral infection in Malwa, India.

Methods: Observational, cross-sectional study. The study population was pregnant women with acute hepatitis E infection confirmed by ELISA technique. Pregnant women with other hepatic viral infections were excluded. All medical and obstetric conditions and mortality were noted on the predesigned proforma.

Results: Out of the total 105 admitted pregnant women with hepatitis E viral infection, 21.90% women had severe morbidity, 24.17% perinatal death and 14 (13.3%) expired before delivery. The yellowish discoloration of urine or sclera was observed in 91.42% with abdominal pain in 76.19%. Maternal mortality was higher in patients with primi (47.82%) and patients presented in second trimester (56.50%).

Conclusions: The acute viral hepatitis E infection in pregnant women is associated with maternal morbidities and high mortality rate.

References

Labrique AB, Sikder SS, Krain LJ, West KP, Christian P, Rashid M, et al. Hepatitis E, a vaccine-preventable cause of maternal deaths. Emerg Infect Dis. 2012;18:1401-4.

Purcell RH, Emerson SU. Hepatitis E: an emerging awareness of an old disease. J Hepatol. 2008;48:494-503.

Aggarwal R, Jameel S. Hepatitis E. Hepatology. 2011;54:2218-26.

Taniguchi M, Kim SR, Mishro S, Takahashi K, Shin MH, Yun H. Epidemiology of hepatitis E in north eastern China, South Korea and Japan. J Infect. 2009;58:232-7.

Goumba CM, Yandoko-Nakoune ER, Komas NP. A fatal case of acute hepatitis E among pregnant women, Central African Republic. BMC Research Notes. 2010;3:103.

Tsega E, Hansson BG, Krawczynski K, Nordenfelt E. Acute sporadic viral hepatitis in Ethiopia: causes, risk factors, and effects on pregnancy. Clin Infect Dis. 1992;14:961-5.

Jilani N, Das BC, Hussain SA, Baweja UK, Chattopadhya D, Gupta RK, et al. Hepatitis E virus infection and fulminant hepatic failure during pregnancy. J Gastroenterol Hepatol. 2007;22:676-9.

Rana A, Pradhan N, Manandher B, Bista KD, Gurung G, Amatya A. Maternal mortality over the last decade: a changing pattern of death due to alarming rise in hepatitis in the latter five-year period. J Obstet Gynecol Res. 2009;35(2):243-51.

Boccia D, Guthmann JP, Klovstad H, Hamid N, Tatay M, Ciglenecki I, et al. High mortality associated with an outbreak of hepatitis E among displaced person in Darfur, Sudan. Clin Infect Dis. 2006;42:1679-84.

Patra S, Kumar A, Trivedi SS, Puri M, Sarin SK. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med. 2007;3(147):28-33.

Bhatia V, Singhal A, Panda SK, Acharya SK. A 20- year single center experience with acute liver failure during pregnancy: is the prognosis really worse? Hepatology. 2008;48(5):1577-85.

Stoszek SK, Abdel-Hamid M, Saleh DA, El Kafrawy S, Narooz S, Hawash Y, et al. High prevalence of hepatitis E antibodies in pregnant Egyptian women. Trans R Soc Trop Med Hyg. 2006;100:95-101.

Navaneethan U. Seroprevalence of hepatitis E infection in pregnancy more questions than answers. Indian J Med Res. 2009;130:677-9.

Kuhroo MS, Kamili S. Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy. J Viral Hepat. 2003;10:61-9.

Kumar A, Beniwal M, Kar P, Sharma JB, Murthy NS. Hepatitis E in pregnancy. Int J Gynecol Ostet. 2004;85:240-4.

Jaiswal SP, Jain AK, Naik G, Soni N, Chitnis DS. Viral hepatitis during pregnancy. Int J Gynecol Obstet. 2001;72:103-8.

Begum N, Polipalli SK, Hssain SA, Kumar A, Kar P. Duration of hepatitis viremia in pregnancy. Int J Gynaecol Obstet 2010; 108:207-10.

Patra S, Kumar A, Trivedi SS, Puri M, Sarin SK. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med. 2007;147:28-33.

Banait VS, Sandur V, Parikh F, Ranka P, Sasaidharan, Sattar A, et al. Outcome of acute liver failure due to acute hepatitis E in pregnant women. Indian J Gastroenterol. 2007;26:6-10.

Beniwal M, Kumar A, Kar P, Jilani N, Sharma JB. Prevalence and severity of acute viral hepatitis and fulminant hepatitis during pregnancy: a prospective study from North India. Indian J Med Microbiol. 2003;21:184-5.

Ahmed RE, Karsrny MS, Adam I. Brief report: acute viral hepatitis and poor maternal and perinatal outcome in pregnant Sudanese women. J Med Virol. 2008;80:1747-8.

Shukla S, Mehta G, Jais M, Singh A. Prospective study on acute viral hepatitis in pregnancy: seroprevalence and fetomaternal outcome of 100 cases. J Biosci Tech. 2011;2:279-86.

Downloads

Published

2017-02-23

Issue

Section

Original Research Articles