Clinical Profile, Laboratory Parameters & Complications in Pregnancy with Jaundice: A Study in DMCH, Dhaka, Bangladesh

Abstract

Background: Pregnancy with jaundice is considered a high-risk pregnancy. It is the most usual health complaint in pregnant women found more often in developing countries than in developed ones. Jaundice can be concurrent with 1st trimester due to pathological infection for instance viral hepatitis or gall stones or due to the drug administered during pregnancy. These patients may feel better if initial diagnosis and suitable management are provided. This present study intended to evaluate the clinical profile & complications of jaundice during pregnancy. Material & Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2012 to June 2012. A total (N=50) of pregnant women with symptoms of jaundice were enrolled in the study. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 16.0. Descriptive inferential statistics were performed to determine the results of this study. Results: Among the study population (N=50), the majority of patients (34, 68.0%) age were between 20 to 24 years. The mean gestational age of patients was 35.3±3.2 weeks and twelve patients (12, 24.0%) underwent caesarean delivery. Based on clinical features, twenty-seven respondents (27, 54.0%) had mild jaundice, fourteen respondents (14, 28.0%) had moderate jaundice & about one-fifth of the patients (9, 18.0%) had severe jaundice. Fifteen pregnant (15, 30.0%) women had a fever, around two-fifth of the patients (19, 38.0%) had vomiting, pruritus in one patient (1, 2.0%), vaginal bleeding in twelve patients (12, 24.05), & more than half of the patients (27, 54.0%) had ruptured membrane. The causes of jaundice during pregnancy were viral hepatitis in forty-three patients (43, 86.0%). The majority of the patients (27,54.0%) had serum bilirubin less than 10mg, fourteen patients (14,28.0%) had 10 to 15mg of serum bilirubin & only one patient (1,2.0%) had serum bilirubin more than 20mg. SGOT & SGPT was found 100-500 IU/ml in twenty-three patients (23,46.0%) & 500-1000 IU/ml in ten patients (10,20.0%). Alkaline was raised in eighteen cases (18, 36.0%) Based on maternal complications, the majority of patients (31, 62.0%) had a postpartum haemorrhage, and ten patients (10, 20.0%) experienced encephalopathy. Thirty-eight babies (38, 76.0%) were born alive, intrauterine death was in seven cases (7, 14.0%), and stillborn in five cases (5, 10.0%). Conclusion: Hepatitis E was the most common cause of viral hepatitis in our study. Major complications were postpartum haemorrhage and encephalopathy. This study also prevailed, jaundice in pregnancy is related to an increase in maternal mortality and morbidity, obstetric complications, and perinatal complications.