Hepatitis E associated fulminant hepatic failure and its outcome in pregnancy.
Objectives: To determine the clinical features and outcome of hepatitis E associated fulminant hepatic failure in pregnancy. Study Design: Observational Retrospective study. Setting: Department of Obstetrics & Gynecology at Isra University Hospital Hyderabad. Period: Three years from 1st January 2015 to 31st December 2017. Material & Methods: Total 3596 obstetric patients were admitted whom 168 pregnant women who were positive for hepatitis E viral marker have been included in the study. Results: Their age was between 18 to 47 years with mean age 26.04±6.40 years; majority of patients had not received antenatal care 123 (73.2%). Out of 168, 27 (16%) presented in the first trimester, 45 (26.7%) presented in the second trimester, while 96 (57.1%) patients developed fulminant hepatic failure in their 3rd trimester of pregnancy. Out of 168, 111(66%) patients delivered and 57 (33.9%) were undelivered. Fetal and perinatal outcome of delivered patients showed miscarriage 45 (40.5%), stillborn 25(14.8%), preterm delivery 17(15.3%), neonatal death 7 (6.3%) and 17 (15.3%) new born remained alive. Overall maternal mortality was 51 (30.3%). Conclusion: Hepatitis – E related fulminant hepatic failure in pregnancy is a troublesome clinical issue and connected with exceptionally high maternal and fetal mortality. Appropriate diagnosis, early timely intervention can considerably diminish the morbidity and mortality associated with (HEV) Fulminant hepatic failure.