Publication:

A study of feto-maternal outcome of jaundice in pregnancy

Background Jaundice in pregnancy complicates 3-5% of cases and carries a grave prognosis. The purpose of the study was to assess the epidemiology, magnitude, causes and the maternal and fetal outcome of pregnancies complicated by jaundice.

Methods The maternal and fetal outcomes of 101 cases of jaundice in pregnancy were reviewed retrospectively from July 2013-June 2016.

Results The incidence of jaundice in pregnancy was 2.32%. Primigravidas constituted 46.53%. Women aged 20-30 years constituted 86.13%. Unbooked cases included 60.39%. Serum bilirubin was >10 mg/dl at admission in 1.98%. Out of the 101 women, 4 remained undelivered. Labor was spontaneous in 53.52%, vaginal delivery in 55.67%. However, 38.63% newborns required NICU care.  Perinatal mortality was 8.91% (3.96% stillbirths and 4.95% early neonatal deaths. The causes for jaundice were viral hepatitis (30.69%), HELLP syndrome (30.69%), intrahepatic cholestasis (15.84%), acute fatty liver of pregnancy (13.86%) and the rest in combination constituted 8.91%. Maternal mortality was 3 in 101. The various maternal complications were DIC (44.55%), septicemia (10.89%), ARDS (7.92%), acute renal failure (8.91%) and MODS (3.96%). ICU was needed in 14.85% of mothers and blood component therapy in 70.29% cases. All deaths were within 3 weeks of admission.

Conclusions This study emphasizes the need for essential antenatal care at domiciliary and peripheral levels. Early detection and treatment can prevent most of the complications.