Cause Of Jaundice In Pregnancy Research Articles

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

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

English

BACKGROUND Jaundice in pregnancy contributes to a significant proportion of maternal and perinatal morbidity and mortality in our country. Overall incidence in India is 1 - 4 per 1000 deliveries. There are increased risks of preterm labour, low birth weight babies, meconium-stained liquor, intrauterine fetal death and postpartum haemorrhage. The purpose of this study was to assess the fetomaternal outcome in pregnancy with jaundice in a tertiary level hospital. METHODS This was a two-year retrospective observational study conducted by reviewing the records of jaundice in pregnancy from April 2018 to March 2020. RESULTS Viral hepatitis comes out as the most common cause accounting for 70.37 % of the cases, whereas intrahepatic cholestasis with an incidence of 20. 37 % comes out as the second aetiology. Post-partum haemorrhage is depicted as the major maternal complication whereas prematurity and birth asphyxia come out as the major perinatal complications. CONCLUSIONS The present study projects viral hepatitis (Hepatitis A and E) as the major cause of jaundice in pregnancy. Although low maternal mortality has been recorded in the present study, a high perinatal mortality due to low birth weight and birth asphyxia remains to be a matter of major concern. KEY WORDS Jaundice in Pregnancy, Viral Hepatitis, Postpartum Haemorrhage, Prematurity, Birth Asphyxia

Jaundice in Pregnancy: A Clinical Study at Fatima Memorial System

ABSTRACT Objective The objective of the study is to find the effect of jaundice during pregnancy on fetomaternal outcome over a 10-year period at tertiary care hospital. Materials and methods An analysis of fetomaternal outcome of all case records with jaundice in pregnancy from January 2003 to December 2013 is made. Results The incidence of jaundice in our study is one in 278 pregnancies, with the disease more common in younger age group. Viral hepatitis found to be the commonest cause, HEV being the commonest with a high maternal and perinatal mortality. Obstetric cholestasis being the second most common followed by HELLP syndrome, AFLP and sepsis; Hepatorenal failure, encephalopathy, DIC and PPH were the main causes of maternal mortality. Conclusion Viral hepatitis is most prevalent cause of jaundice in pregnancy, associated with a high maternal and perinatal mortality and morbidity. How to cite this article Ambreen A, Ahmed F, Sheikh A, Ayub MR, Faryad N, Mushtaq S. Jaundice in Pregnancy: A Clinical Study at Fatima Memorial System. J South Asian Feder Obst Gynae 2015;7(1):22-25.

Colestasis y listeriosis en el tercer trimestre de la gestación

Listeriosis is an infection produced by Listeria monocytogenes. It is infrequent and affects people at extreme ages, pregnant women, immunocompromised people and, occasionally, healthy people. Its incidence has increased in recent years and shows a certain tendency to seasonality, increasing in summer. It can appear sporadically or as outbreaks. In pregnant women the infection is most frequently produced in the third trimester and the symptoms are usually light. Nonetheless, the infection of the fetus is severe, and can produce miscarriages, fetal deaths, corioamnionitis and premature births with the newborn infected, manifested in the form of granulomatosis infantiseptica with abscesses and scattered granulomas or at a later stage , as meningitis or sepsis. Intrahepatic cholestasis is a reversible form of cholestasis, its cause is unknown, it is specific to pregnancy and is more frequent in multiparous women, in the third trimester and rarely before the 26th week. It disappears following childbirth and is the second cause of jaundice in pregnancy, after hepatitis. The diagnosis of cholestasis is basically clinical. It appears as palmoplantar pruritus but can also produce nausea, vomiting and abdominal discomfort localized in the right hypochondrium. Given that listeriosis and cholestasis can have a shared symptomology, the possibility of listeriosis must be borne in mind in order for early implementation of the mechanisms of diagnostic confirmation (cultivation of sterile fluids or tissues: blood, neonatal CSF, amniotic liquid or placenta) and specific treatment. We present a case of cholestasis and listeriosis in the third trimester with a good maternofetal result.

An unusual cause of obstructive jaundice in pregnancy

We present a unique case of jaundice in pregnancy, secondary to common bile duct obstruction by an unusual internal colonic hernia. We also illustrate the benefits of using non-ionizing imaging modalities in the diagnosis and pre-operative planning of this rare condition.

An unusual cause of jaundice in pregnancy

An unusual cause of jaundice in pregnancy

Liver disease during pregnancy: acute viral hepatitis: Symposium on liver & pregnancy

Acute viral hepatitis is the most common cause of jaundice in pregnancy. The course of most viral hepatitis infections (e.g., hepatitis A, B, C and D) is unaffected by pregnancy, however, a more severe course of viral hepatitis in pregnancy has been observed in patients with hepatitis E. Notwithstanding, opinions differ over the maternal and fetal outcome of pregnancy associated with viral hepatitis. While some authors reported that acute viral hepatitis carries a high risk for both mother and fetus others conclude that non-fulminant viral hepatitis did not influence the course of pregnancy or fetal well-being. Rate of transmission of the virus during pregnancy depends on the virus. For instance, intra-utero transmission of hepatitis A virus is very rare, but perinatal transmission could occur. Conversely sixty percent of pregnant women who acquire acute HBV infections at or near delivery will transmit the HBV virus to their offspring and mother to child transmission of hepatitis E virus infection was established between 33.3 and 50%. Breast-feeding is not contra-indicated in women infected with the hepatitis A, E or C. However, for acute hepatitis B, with appropriate immunoprophylaxis, including hepatitis B immune globulin and hepatitis B vaccine, breast-feeding of infants of HBV infected mother’s poses no additional risk for the transmission of the hepatitis B virus. Finally, whether live or inactivated vaccines are used, vaccination of pregnant women should be considered on the basis of risks versus benefits. Pregnant women who think they may have been exposed to hepatitis B may be given and hepatitis B immunoglobulin (ideally within 72 hours of exposure), as well as the hepatitis B vaccine.

Stéatose hépatique aiguë gravidique chez une addisonienne

A case is reported of acute fatty liver occurring in an Addisonian woman with a twin pregnancy. It is pointed out that Sheehan's syndrome or acute fatty liver of pregnancy is an exceptional cause of jaundice in pregnancy. Its severity is due to the syndrome, associating hepatic failure and renal, pancreatic and haemorrhagic complications. The history of the pregnancy and the past medical history are of less import for the outcome. The best treatment is delivery by caesarean section, together with symptomatic treatment of the complications. In case of jaundice of unknown aetiology in late pregnancy, the advantages of an early diagnosis by transjugular hepatic biopsy are discussed.