Maternal and fetal outcome in jaundice complicating pregnancy: a prospective study

Abstract

Background: The objective of the study was to study maternal and fetal outcome in pregnancy complicated with jaundice. Methods: 30 antenatal patients with clinical /laboratory evidence of Jaundice were selected for study in period between august 2014 to august 2015. Results: The peak age of incidence in our study was 21-25 years (66.6%) and majority were primigravida (66.6%). All cases were in third trimester of pregnancy, 93.3% were unbooked, 73.3% were term, 60% were of lower socioeconomic status and 73.3% were urban. All patients presented with jaundice at time of admission. Pruritus was most common presenting symptom present in 60% of patients. Other presenting complaints were nausea, high BP, abdominal pain and petechiae. Viral Hepatitis was most important cause of jaundice in this study found in 46.7% of cases. Preeclampsia and ICP were other causes of jaundice in this study. Hepatitis B was the most common cause of acute hepatitis (26.7%) and incidence of hepatitis E was 13.3% in our study. Maternal mortality was found in 1 case of hepatitis E complicated with hepatic encephalopathy and coagulopathy. 2% of these patients developed FHF. All patients were kept in ICU for intensive monitoring. PPH was most common maternal complication in 60% of patients. There was 1 maternal death in our study. Of 30 patients, 12 had spontaneous onset of labour. All delivered vaginally of which 8(26.7%) were preterm of which 2 died, 4(13.3%) were IUFD, 12 (40%) had fetal distress with meconium stained liquor, 5 (16.6%) had PROM, 2 (6.7%) had fetal growth restriction and 2 (6.7%) delivered uneventfully. Conclusions: Jaundice in pregnancy results in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management.