Deleterious impact of maternal hepatitis-C viral infection on maternal and fetal outcome: a 5-year prospective study.

Abstract

To assess prospectively the maternal and fetal outcome among pregnant women with chronic Hepatitis-C virus (HCV) infection compared to normal control group. A prospective observational study conducted on 342 pregnant women with HCV who were divided into two groups according to polymerase chain reaction (PCR) result, group 1 (n=184, HCV-PCR negative) and group 2 (n=154, HCV-PCR positive) with a third group of normal pregnant women (n=170). Obstetric outcome was recorded. Patients with positive HCV-PCR have more elevated liver enzymes (p<0.05) and lower prothrombin INR (p<0.001) than those with negative HCV-PCR testing. Fewer patients with HCV received previous medical treatment (16/342, 4.6%). More women in the HCV groups delivered by vacuum or cesarean section (p<0.05), experienced higher rates of antepartum hemorrhage, postpartum hemorrhage, anemia, development of GDM, premature rupture of membranes, repeated hospital admissions, blood transfusions, admission to ICU and maternal mortality (p<0.001) compared to the control group. Fetuses of women with HCV infections were more prone to IUFD with higher rates of low birth weight, prematurity, low Apgar scores at 5min, admission to NICU, need for ventilation, and acquisition of HCV (p<0.001) as well as neonatal mortality (p<0.05) compared to the control group. Patients with HCV infection even those without viremia suffered poor maternal and fetal outcome. Multidisciplinary management of the affected patients should be implemented to improve their obstetric outcome.