Hepatitis E viral infection in pregnant ladies, a challenge for obstetricians and physicians

  • Authors

    • Samia Jamil King Edward Medical University, Lahore
    • Hafiz Muhammad Sajid Jehangir King Edward Medical University, Lahore
    • Hamza Naeem King Edward Medical University, Lahore
    • Mahliqa Maqsud King Edward Medical University, Lahore
    • Mehwish Ayyaz King Edward Medical University, Lahore
    • Tayyaba Kanwal King Edward Medical University, Lahore
    • Sarmad Zahoor King Edward Medical University, Lahore
    • Muhammad Umer Mukhtar King Edward Medical University, Lahore
    • Malik Muhammad Atif king Edward Medical University, Lahore
    • Raza Manzoor Haideri king Edward Medical University, Lahore
    2021-05-01
    https://doi.org/10.14419/ijm.v9i1.31468
  • Hepatitis E Virus, Pregnancy, RNA virus, Immunoglobulin.

  • Background: Hepatitis E Virus (HEV) is the major cause of morbidity and mortality in pregnancy. The virus was detected about three decades ago. The incidence and severity during pregnancy vary widely around the world.

    Material & Methods: This observational retrospective study was conducted from March 2019 to February 2020 in Obstetrics & Gynecology Department of Lady Aitchison Hospital, Lahore. 70 pregnant women with hepatitis E were subjected to detailed history taking. The diagnosis was based on positive Hepatitis E IgM (Anti HEV IgM) antibody on laboratory test in current pregnancy in antenatal period up to 42 days post partum were included.

    Results: Out of 70 pregnant women with Hep E IgM+ve, 3 (4.3%) women had Obstetrical hysterectomy as complications, with mean age of 26.0 ± 4.69 years. The mean gestational age when infection occurred was 31.12 ± 5.18 weeks. Among all females 9 (13%) patients expired due to fulminant hepatic failure, 12 (17.14%) females gave birth via spontaneous vaginal delivery (SVD),17(24.2%) females gave birth via C-Section. 30 (42.8%) females were manage conservatively.

    Conclusion: Hepatitis E viral infection in pregnant females is a life threatening condition. The study showed that pregnant women with jaundice and hepatitis E virus infection had a high mortality rate during third trimester. Early diagnosis and management will help in the control of the disease and prevents its complications.

     

     


     

  • References

    1. [1] Capai L, Falchi A, Charrel R. Meta-Analysis of Human IgG anti-HEV Seroprevalence in Industrialized Countries and a Review of Literature. Viruses2019;11(1):84.https://doi.org/10.3390/v11010084.

      [2] Hughes JM, Wilson ME, Teshale EH, Hu DJ, Holmberg SD. The Two Faces of Hepatitis E Virus. Clinical Infectious Diseases2010;51(3):328-34.https://doi.org/10.1086/653943.

      [3] Krain LJ, Nelson KE, Labrique AB. Host Immune Status and Response to Hepatitis E Virus Infection. Clin Microbiol Rev2014;27(1):139-65.https://doi.org/10.1128/CMR.00062-13.

      [4] Dagnew M, Belachew A, Tiruneh M, Moges F. Hepatitis E virus infection among pregnant women in Africa: systematic review and meta-analysis. BMC infectious diseases 2019;19(1):519.https://doi.org/10.1186/s12879-019-4125-x.

      [5] KasperL, FauciJ.Acuteviralhepatitis.Harrison’sPrincInternMed2015;2(18):2537- 55.

      [6] Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clinical microbiology reviews 2014;27(1):116-38.https://doi.org/10.1128/CMR.00057-13.

      [7] Khaskheli M-N, Baloch S, Sheeba A, Baloch S. Acute hepatitis E viral infection in pregnancy and maternal morbidity. J Coll Physicians Surg Pak2015;25(10):734-7.

      [8] Yasmeen T, Hashmi HA, Taj A. Fetomaternal outcome with hepatitis e in pregnancy. J Coll Physicians Surg Pak2013;23(10):711-4.

      [9] Rein DB, Stevens GA, Theaker J, Wittenborn JS, Wiersma ST. The global burden of hepatitis E virus genotypes 1 and 2 in 2005. Hepatology2012;55(4):988-97.https://doi.org/10.1002/hep.25505.

      [10] Patra S, Kumar A, Trivedi SS, Puri M, Sarin SK. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Annals of internal medicine 2007;147(1):28-33.https://doi.org/10.7326/0003-4819-147-1-200707030-00005.

      [11] Boutrouille A, Bakkali-Kassimi L, Crucière C, Pavio N. Prevalence of anti-hepatitis E virusantibodiesinFrenchblooddonors.Journalofclinicalmicrobiology2007;45(6):2009-10.https://doi.org/10.1128/JCM.00235-07.

      [12] Mansuy J-M, Bendall R, Legrand-Abravanel F, Sauné K, Miédouge M, Ellis V, et al. Hepatitis E virus antibodies in blood donors, France. Emerging infectious diseases 2011;17(12):2309.https://doi.org/10.3201/eid1712.110371.

      [13] Sultana R, Humayun S. Fetomaternal outcome in acute hepatitis E. J Coll Physicians Surg Pak2014;24(2):127-30.

      [14] Khuroo M, Kamili S. Aetiology, clinical course and outcome of sporadic acute viral hepatitis in pregnancy. Journal of viral hepatitis2003;10(1):61-9.https://doi.org/10.1046/j.1365-2893.2003.00398.x.

      [15] Jethwa D, Chauhan D, Badrakiya G, Badrakiya S. Hepatitis E virus in pregnancy with fetomaternal outcome-A prospective study. Journal of Dental and Medical Sciences 2015; 14:25-8.

      [16] Shrestha P, Bhandari D, Sharma D, Bhandari B. A study of viral hepatitis during pregnancy in Nepal Medical College Teaching Hospital. Nepal Medical College journal: NMCJ 2009;11(3):192.

      [17] Brohi ZP, Sadaf A, Perveen U. Etiology, clinical features and outcome of fulminant hepatic failure in pregnancy. Age (years)2013;29(8.404):17-42.

      [18] Mishra S, Jha RK, Thakur R, Tiwari S. Study of maternal and prenatal outcome in pregnantwomenwithacutehepatitisEviralinfection.IntJReprodContraceptObstetGynecol 2016;5(7):2300-3.https://doi.org/10.18203/2320-1770.ijrcog20162115.

      [19] Mayadeo NM, Shah SN. Pregnancy outcome with hepatitis E infection. International Journal of Reproduction, Contraception, Obstetrics andGynecology;8(2):468.https://doi.org/10.18203/2320-1770.ijrcog20190269.

      Shinde N, Patil T, Deshpande A, Gulhane R, Patil M, Bansod Y. Clinical profile, maternal and fetal outcomes of acute hepatitis e in pregnancy. Annals of medical and health sciences research 2014;4(8):133-9.https://doi.org/10.4103/2141-9248.138033

  • Downloads

  • How to Cite

    Jamil, S., Muhammad Sajid Jehangir, H., Naeem, H., Maqsud, M., Ayyaz, M., Kanwal, T., Zahoor, S., Umer Mukhtar, M., Muhammad Atif, M., & Manzoor Haideri, R. (2021). Hepatitis E viral infection in pregnant ladies, a challenge for obstetricians and physicians. International Journal of Medicine, 9(1), 54-57. https://doi.org/10.14419/ijm.v9i1.31468