Maternal and fetal outcome in jaundice complicating pregnancy: A prospective study at a tertiary care hospital

Abstract

Background: The main objective of the study is to evaluate the maternal and fetal outcome in patients with jaundice complicating pregnancy in a tertiary care hospital. Methods: This is an observational study was conducted in Government Thanjavur Medical College, Thanjavur, Obstetric and gynecologist department, Tamil Nadu, India. All Antenatal women with jaundice complicating pregnancy cases during one year period From August 2016 to July 2017. Different parameters including age, parity, gestational age, booking status, mode of delivery, maternal complications, Perinatal outcome in terms of birth weight, perinatal morbidity and mortality were studied. Results: Incidence of jaundice in this study was 0.4%, of this 65 women studied 56.9% in the age group of 21- 25 years,mean age is 24 years, 1 case were occurred in >35 years of age which is about 1.53%. The incidence is most commonly involved in primigravidas 61.5% and multigravidas 38.5%. Third trimester is commonly involved in jaundice about 87.6%. 96.9% of the patients studied were booked and 3.1% were unbooked, 92.3% of the patients referred from peripheral hospitals. 32.3% presented with icterus, 46.1% presented with mild paller, pedal edema were reported in 30.7% of cases, most common cause of jaundice in this study was viral infection 43.1%. Most commonly involved virus is hepatitis B virus 89.2%, hepatitis A is 1.53%, hepatitis C 1.53% Of this 55.9% delivered by LSCS and 45.24% delivered vaginally. Atonic pph is the most common complication 10.7%, abruption were reported in 1.5% cases. Term babies were 70.9%, preterm were 24.3%, 50.8% were male and 49.2% were female. Maternal complication rate 24.61%. 8 case of maternal death. Most common cause for death is HELLP syndrome. Live births were 91.5% and 8.5% diagnosed as IUFD. Conclusion: Jaundice complicating pregnancy is associated with increased maternal mortality and morbidity in developing countries like India and significant role in maternal and fetal outcome. Thus it becomes necessary to create more awareness about the importance of regular antenatal care, health education, early diagnosis and appropriate timely treatment to ameliorate many cases and to bring out a satisfactory maternal and fetal outcome.