A study of fetomaternal outcomes in cases of jaundice at a tertiary care centre

Background: Liver disorders in pregnancy encompass a spectrum of diseases encountered during antenatal and postnatal period resulting in abnormal liver function tests and hepatobiliary dysfunction or both. This study is aimed at determining the causes of liver disorders during pregnancy and associated maternal and fetal outcomes over a period of 3 years at a tertiary care centre of Dehradun.Methods: All case records of patients with liver disorders during pregnancy from May 2013 to May 2016 were retrieved from medical record department of SGRRIMHS, Dehradun and analyzed for various causes of liver disorders and associated maternal and fetal outcomes.Results: During the three-year study period, 146 pregnant patients were found to have liver disorders. The study found that viral hepatitis was the most common cause of liver disorders followed by Intrahepatic cholestasis of pregnancy IHCP. There were 6 mortalities among the study group out of which hepatitis E was the culprit for maternal mortality in two patients. The serum bilirubin levels were directly proportional to the maternal deaths.Conclusions: Liver disorders during pregnancy are rare but an important cause of maternal and fetal morbidity and mortality. Early recognition, timely referral and aggressive management may lead to better maternal and fetal outcome.

Section: Discussionsupporting

confidence: 84%

Overview of liver disorders during pregnancy at a tertiary care centre: Uttarakhand scenario

Ramola¹,

Jain²,

Gupta³

et al. 2017

“…This is comparable to result Satia MN et al showed 0.81% incidence of jaundice. 4 Most of the patients 77.13% belonged to age group 20-29 years, this could be due to early marriage and early childbearing in our country. 77.14% patients were emergency admission and most of them from rural area i.e 77.71%.…”

Section: Discussionmentioning

confidence: 79%

“…Satia MN et al showed 0.81% incidence of jaundice. 4 Out of the 70 patients, 53 patients (75.71%) belonged from the rural area and 17(24.28%) from the urban set up. 16(22.85%) patients were registered and the other 54(77.14%) were referred during emergency from other peripheral hospitals.…”

Section: Resultsmentioning

confidence: 95%

A clinical study on fetomaternal outcome in jaundice with pregnancy

Padh

Shah

Vyas

et al. 2019

Background: Jaundice in pregnancy and pregnancy in women with preexisting liver disease is not very uncommon. However it takes a major toll on health of both mother and fetus, due to increased morbidity and mortality for both mother and fetus, categorizing pregnancy as a high risk one. The distribution of jaundice in pregnancy varies throughout the world, but is seen more in developing countries. The course and outcome of liver disorder in pregnancy is altered due to various hemodynamic, hormonal and immunological changes unique to pregnancy. The hepatic functions during pregnancy are affected by increase in serum estrogen and progesterone levels.Methods: This was a prospective study of 70 cases of pregnancy with jaundice admitted in the department of obstetrics and gynecology at Sheth V.S. General Hospital, Ahmedabad, Gujarat, India. The duration of study was from June 2015 to December 2018. During this period 70 patients were admitted with jaundice in pregnancy. Patients were analyzed with regards to socio demographic profile, investigations, maternal and perinatal outcome.Results: The incidence of pregnancy with jaundice in present study was 0.32%. Most common cause identified was viral hepatitis in 27 cases (38.57%) out of which 23(32.85%) cases being hepatitis E. Followed by HELLP syndrome, pre eclempsia, eclempsia in 24(34.28%) cases. 13(18.57%) cases were belonged to cholestatic jaundice of pregnancy. Rest 6(8.56%) cases belonged to malaria, portal hypertension due to liver disease etc. Out of total 70 patients 53(75.71%) women from rural area, 54(77.13%) patients were from age group of 20-29years.Maximum patients were multigravida i.e. 28 (40%) and 66(94.28%) women coming from lower middle and lower socio economic class. There were 9 maternal deaths, 5 due to DIC. Total vaginal deliveries were 40, 24 patients underwent LSCS, 4 patients had abortion, and 2 expired undelivered. Most common complication was DIC in 16(22.85%) cases and thrombocytopenia in 14(31.67%) cases. 30(42.85%) babies were LBW and 18(25.7%) babies were IUGR.Conclusions: Prompt diagnosis and accurate evaluation and multidisciplinary approach of management in pregnancy with jaundice at a tertiary care center with good NICU is helpful in reducing maternal and perinatal mortality and morbidity.

“…3 In a study conducted in 2016 at Seth G S Medical College, the incidence reported was 0.81%. 9 This shows that the incidence of liver diseases not only varies globally but varies from region to region within the same country.…”

Section: Discussionmentioning

confidence: 95%

“…8 In another study conducted by Meena et al, at Seth G S Medical College found a similar distribution with 59 % of women belonging to less than 25 years of age. 9 In a clinical study at Fathima Memorial System, Pakistan in 2015 reported a clustering of 71.02% of women with liver disease in the age group 20-30 years. 10 This finding may be due to the fact that those women in this age group are the most reproductively active females.…”

Section: Discussionmentioning

confidence: 99%

Aetiology of jaundice in pregnancy: observational study in a tertiary care hospital

Anaswara

2019

Background: Jaundice in pregnancy has potentially serious consequences to both mother and foetus. This study aims to find out the aetiology of jaundice and its severity in pregnancy.Methods: This is an observational prospective study over a period of one and a half years conducted in the Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode. Antenatal patients who presented with jaundice was included in this study.Results: Out of 24060 deliveries in the study period of one and a half years there were 52 cases of jaundice complicating pregnancy. Incidence of jaundice complicating pregnancy was found to be 0.22%. Largest number of women belonged to the age group 21-25 years of age. Most of the cases occurred in the third trimester. 55.8% of the cases were multigravidas Most common cause of jaundice in pregnancy was found to be HELLP syndrome (34.6%) followed by Hepatitis A (32.7%) 67.3% of the cases had only mild elevation of bilirubin levels (2-5.9mg/dl). 65.4% had an SGOT value of less than 200U/litre and 67.3 % had an SGPT value of less than 200U/litre.Conclusions: The decrease in the number of cases of viral hepatitis may be due to the increased awareness about the transmission of disease and improvement in sanitary conditions.