Maternal and fetal outcome in jaundice complicating pregnancy

Abstract

Objective: This study is aimed at determining maternal and fetal outcome in women with jaundice complicating pregnancy. Materials and Methods: An analysis of maternal and fetal outcome of 18 pregnant women admitted with jaundice during June 2012 to May 2013. Results: All cases in this study were in their third trimester of pregnancy. Serum bilirubin was >10 mg in 8 (44.4%) cases. In patients with jaundice related to pregnancy serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase and alkaline phosphatase were raised in a majority of them. Hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, acute fatty liver of pregnancy, intrahepatic cholestasis of pregnancy, viral hepatitis, malaria and sickle cell anemia were the causes of jaundice in this study. In this study, HELLP syndrome (33.3%) was the most common cause of jaundice. Of 18 women, 10 (55.6%) of women the onset of labor was spontaneous and 16 (88.9%) delivered vaginally. Perinatal mortality in 6 cases (33.3%) among them 1 (16.6%) stillbirth and 5 (83.3%) intrauterine deaths. 15 (83.3%) women were discharged in improved condition. Maternal mortality in 3 cases (16.66%) 1 case died within 24 h of delivery, 1 on the 4 th postnatal day and 1 on the 8 th postnatal day. Cause of death was acute fatty liver of pregnancy with multiorgan failure with disseminated intravascular coagulation (DIC) with shock in 2 cases, HELLP syndrome with DIC with renal failure in 1 case.Conclusion(s): Jaundice and pregnancy is a deadly combination resulting in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management.