Pregnancy Outcome in Acute Viral Hepatitis E

Abstract

Background: Hepatitis E is associated with poor feto-maternal outcome. Patients with acute hepatitis E who are pregnant usually require hospital admission and monitoring with liver function tests and clotting profile. Objective: To evaluate maternal and fetal outcome among pregnant women who have positive serology for hepatitis E IgM. Methods: Data of women with clinical presentation of jaundice during pregnancy and who were diagnosed as acute hepatitis E was collected on pre-structured questionnaire after obtaining consent. Data were entered in Statistical Package for Social Sciences for analysis. Results: Three hundred and thirty three women had positive serology for hepatitis E IgM. Out of these three hundred were in last trimester of their pregnancy. The gestational age of two hundred and thirty two (77%) women was less than 37 weeks at presentation. Six (2%) pregnancies ended up in miscarriage, fifty four (16 %) had fetal demise in maternal womb while two hundred and seventy three (82%) were viable fetus. One third of live born babies were kept in NICU. Indications of neonatal admission were respiratory distress in 57(72%), jaundice neonatorum in 12(15%), asphyxia neonatorum in 9(12%), while one (1%) had transient tachypnea. Neonates who died in first week of their life were 18(23%).The cause of neonatal death was respiratory distress in 12 (67%) and anoxia in remaining 6 (33%) neonates. Most of the women were discharged home however maternal mortality was recorded in 80(24%) patients, mainly in postpartum period 73(91%). Conclusion: Pregnant women with acute hepatitis E have more complicated course of this viral infection with adverse fetal and maternal implications.