Fulminant hepatic failure during pregnancy.


  • Zahra Nazish Nishtar Medical University, Multan.
  • Muhammad Inayatullah Nishtar Medical College, Multan. Multan Medical and Dental College, Multan.
  • Fatima Tu Zahra Nishtar Medical University, Multan.




Fulminant Hepatic Failure, Maternal Outcome, Pregnancy


Objective: To observe clinical characteristics, etiology and maternal outcome in fulminant hepatic failure during pregnancy. Study Design: Descriptive Case Series. Setting: Department of Medicine, Nishtar Hospital Multan. Period: January 2013 to December 2017. Material & Methods: Twenty nine consecutive patients with fulminant hepatic failure during pregnancy were included in the study. Results: Mean age of patients was 27.06±6.92 years. 65.51% patients were from urban areas. Mean duration of gestation was 24.80±6.03 weeks. Jaundice and altered consciousness were observed in 100% cases, pallor in 79.31%, hepatomegaly in 20.68%, flapping tremors in 10.34%, ascites in 10.34% and splenomegaly in 6.89% cases. Complications observed were cerebral edema in 44.82%, renal failure in 24.13%, bleeding in 20.68% and hypoglycemia in 3.44%. Most common cause was acute hepatitis E (75.86%) followed by hepatitis B (13.79%) and hepatitis A (3.44%). No cause was found in 6.89% cases. Overall maternal mortality was 37.93% and fetal mortality was 72.41%. In 17.24% cases pregnancy was terminated therapeutically, 44.82% cases had spontaneous expulsion and in 37.93 % cases pregnancy continued. Maternal mortality was highest (45.45%) in patients who remained pregnant as compared to 20% when pregnancy was terminated therapeutically. Conclusion: Jaundice and altered conscious level is the most common clinical presentation. Hepatitis E is the most common cause of FHF in pregnancy. Maternal mortality in FHF during pregnancy is very high.

Author Biographies

Zahra Nazish, Nishtar Medical University, Multan.


Associate Professor Medicine


Muhammad Inayatullah, Nishtar Medical College, Multan. Multan Medical and Dental College, Multan.


Professor / HOD Medicine

Fatima Tu Zahra, Nishtar Medical University, Multan.

Final Year MBBS Student