Title: Spectrum of Foeto-maternal outcome in Jaundice with Pregnancy: An Insight
Authors: Dr Ritu Khatuja, Dr Chhavi, Dr Mini, Dr N Sarda
DOI: https://dx.doi.org/10.18535/jmscr/v7i5.113
Abstract
Background: The incidence of Jaundice in pregnancy is 3% to 5%. The causes of jaundice in pregnancy can be coincidental liver disease, underlying chronic disease and condition related to pregnancy. Management of pregnant women with jaundice is very challenging because accurate diagnosis sometimes is very difficult and delay in management can be life threatening.
Objectives: The aim of the study was to evaluate the etiology of the jaundice among pregnant women, their management and outcome.
Methodology: A clinical audit was done in Department of Obstetrics and Gynaecology at Dr BSA Medical College and Hospital among pregnant women with jaundice who were admitted in the hospital over a period of four months.
Results: A total of 48 pregnant women with jaundice were admitted in hospital over the period of 4 months. All most all of them were in third trimester except three. Twenty four women were diagnosed as viral hepatitis with six women had hepatitis E. Ten women suffered from Intrahepatic cholestasis of pregnancy and 2 from obstructive jaundice (gallbladder stones and Common Bile Duct stones) and ten from hypertensive disorder in pregnancy and two had malaria. Almost half of women (n=25) had preterm delivery and 12 women delivered by caesarean section (of these nine had preterm CS). Three women (7.14%) had maternal mortality. All the three mortality belonged to hypertensive disorder in pregnancy and its associated complication. Perinatal mortality was 16.7% and all of them were preterm deliveries.
Conclusion: The disease is associated with high incidence of preterm labour. Main cause of maternal mortality was found to be hypertensive disorder in pregnancy and its sequel (coagulation failure, renal failure, septicaemia, hepatic failure) and main causative factor for perinatal mortality was prematurity and related problems.
Keywords: Pregnancy, Jaundice, Viral markers, Hepatic encephalopathy.