Foetomaternal Outcomes of Jaundice in Pregnancy at a Tertiary Care Centre: A Prospective Cohort Study

Abstract

Introduction: Jaundice complicates 3 to 5% of pregnancies and is one of the important causes of maternal and neonatal morbidity and mortality worldwide. It is responsible for approximately 10% of maternal deaths. Aim: To study the prevalence of jaundice in pregnancy, evaluate the important causes of jaundice encountered in pregnancy, and study the effects of jaundice during pregnancy on both maternal and foetal outcomes. Materials and Methods: This prospective cohort study was conducted at the Department of Obstetrics and Gynaecology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India, from March 1, 2021, to August 31, 2022. A total of 90 cases of pregnancy with jaundice were included in the present study. Detailed history, clinical examination, laboratory investigations, diagnosis, management, and outcomes in terms of maternal and perinatal morbidity and mortality were recorded. Data were analysed using the Chi-square test, with a statistical significance level set at p<0.05. Results: The total number of deliveries was 20,087, out of which 90 (0.45%) patients had jaundice. The prevalence of jaundice in pregnancy was 4.5 per 1000. The aetiologies of jaundice were viral hepatitis in 23 cases (25.55%), followed by intrahepatic cholestasis in 22 cases (24.44%), preeclampsia in 13 cases (13.33%), and Haemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) syndrome in 6 cases (6.66%). There were 12 (13.33%) maternal deaths and 17 (18.88%) neonatal deaths. Two (2.22%) babies were stillborn, and 1 (1.11%) case experienced Intrauterine Foetal Death (IUFD). The maternal death rate due to HELLP syndrome was 66.66% (4 deaths out of 6 cases). Conclusion: Viral hepatitis is the most common cause of jaundice in pregnancy. Although viral hepatitis due to the faecooral route is more common in India, the present study showed that Hepatitis B is more common during pregnancy