A study to understand maternal and fetal outcome of jaundice in pregnancy

Abstract

Background: Incidence of jaundice in pregnancy, including underlying chronic liver diseases, is 3–5%. However, the maternal mortality rate in some conditions can be as high as 18% in acute fatty liver of pregnancy and 22% in hepatitis E in pregnancy. Objectives: This is an observational study of the demographics, obstetrical profile, aetiology, maternal morbidity, mortality and neonatal outcomes in pregnancies complicated with jaundice. Materials and Methods: This is an observational study conducted in Department of Obstetrics and Gynaecology of a tertiary care hospital from June 2012 to November 2014. All such patients were prospectively followed throughout the pregnancy and intrapartum period and their outcomes were studied. Results: Most of the cases of jaundice in pregnancy were seen in primigravida and age group of 20.1-30 yrs. Hepatitis was the most common cause (12.79%) of jaundice in pregnancy. The most common presenting symptom was abdominal pain in 84.88% . 95.35% of the patients delivered, 48.85% had preterm delivery and 46.5% of patients delivered at term. In our study maternal mortality due to jaundice is 23.25%. which is 12.57% of overall mortality. Conclusion: Jaundice in pregnancy is mainly due to viral hepatitis. It is very high in lower socio-economic, densely populated urban slums. Special efforts should be made to counsel and educate the mothers about initial symptoms and preventive measures for viral hepatitis. Patients along with the relatives should be informed about the symptoms of severe pre-eclampsia to combat these preventable causes of maternal mortality.