July 2016 · Volume 5 · Issue 7 Page 2300
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Mishra S et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jul;5(7):2300-2303
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Research Article
Study of maternal and prenatal outcome in pregnant women with acute
hepatitis E viral infection
Sunita Mishra
1
*, Rajesh Kumar Jha
2
, Ratna Thakur
1
, Sindhuja Tiwari
1
INTRODUCTION
Hepatitis E Virus (HEV) is a major aspect of hepatitis
and death in the developing countries and asymmetrical
source of deaths in among of pregnant women.
1
HEV is a
single stranded, non-enveloped RNA virus and is the only
virus within the genus hepevirus and the family
hepaviridae.
2,3
It was first reported in India in 1970s.
4
HEV is befalling a major public health problem in world.
In pregnant women, maternal age in addition to
hormonal, immunological and environmental factors may
be the risk factor for fatal and maternal morbidity.
5
HEV infection has been observe to have high attack rate
in pregnant women and associated high maternal
mortality and perinatal mortality rate.
6
The actual source
of high mortality in pregnant women is still not known. It
may be due to an altered status of hormones and
immunity, which was observed during pregnancy in a
study done by Jilani et al.
7
HEV infection is emerging as
a number one killer of pregnant women in India.
8
Recently, an epidemic of HEV with high maternal
mortality was reported among Sudanese women in Darfur
as well as in India.
9,10
However, despite the evidence of
high mortality of pregnant women with HEV infection,
Bhatia et al observed that outcome of HEV infection
during pregnancy is not different when compared with
age matched non-pregnant women and men.
11
There are
conflicting reports also from developed countries where
no adverse effect has been observed on the course of
infection during pregnancy.
12
This observational, cross-sectional study was done to find
out the prevalence of HEV infection among the
1
Department of Obstetrics and Gynaecology,
2
Department of Medicine Sri Aurobindo Medical College and Post
Graduate Institute, Indore, Madhya Pradesh, India
Received: 14 May 2016
Accepted: 06 June 2016
*Correspondence:
Dr. Sunita Mishra,
E-mail: dr_sunitamishra_16@yahoo.co.in
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Hepatitis E Virus (HEV) is a major aspect of hepatitis and death in the developing countries and
asymmetrical source of deaths in among of pregnant women. The objective of this study was to determine the
maternal and prenatal outcome in pregnant women with acute hepatitis E viral infection in Malwa, India.
Methods: Observational, cross-sectional study. The study population was pregnant women with acute hepatitis E
infection confirmed by ELISA technique. Pregnant women with other hepatic viral infections were excluded. All
medical and obstetric conditions and mortality were noted on the predesigned proforma.
Results: Out of the total 105 admitted pregnant women with hepatitis E viral infection, 21.90% women had severe
morbidity, 24.17% perinatal death and 14 (13.3%) expired before delivery. The yellowish discoloration of urine or
sclera was observed in 91.42% with abdominal pain in 76.19%. Maternal mortality was higher in patients with primi
(47.82%) and patients presented in second trimester (56.50%).
Conclusions: The acute viral hepatitis E infection in pregnant women is associated with maternal morbidities and
high mortality rate.
Keywords: Pregnancy, Hepatitis E, Central India
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20162115