Research
Fetomaternal Outcome in Pregnancy with Hepatitis E Infection
Background: HEV infection, a major public health concern, is known to cause largescale epidemic and sporadic cases of acute viral hepatitis in developing countries. The infection occurs primarily in young adults and is generally mild and self-limiting; however, the case fatality rate is reportedly higher among pregnant women. Methods: Our study, a retrospective observational study, was conducted in a tertiary care centre for over a period of 3 years (Jan 2017 to Jan 2020) to find out the fetal and maternal outcome in pregnant women with HEV infection. Results: A total of 38antenatal cases with Anti-HEV IgM-positive were included, and the maternalfetal outcome was analyzed. The maternal mortality was 52.63% especially during 3rd trimester and post-partum period, including 5 antenatal death. The most common maternal complication was acute fulminant hepatitis (39.5 %), DIC (36.8 %) and hepatic encephalopathy (31.6%). Prematurity (33.3% of total live births) and Still births (32.3 %) including4fresh still births were the commonest fetal complications noted.
Severe Oligohydramnios with Good Fetal Outcome
Amniotic fluid provides a protected milieu for the growing fetus , cushioning the fetus against mechanical and biological injury, supplying nutrients and facilitating growth and movement. Oligohydramnios is defined as a single pocket measuring 2 cm in both vertical and horizontal planes or AFI less than 5 cm. Incidence of oligohydramnios varies between 0.5 to > 5 %. Causes of oligohydramnios: • Maternal – postdated pregnancy, PPROM, hypertension, autoimmune disorders and maternal medications like prostaglandin synthetase inhibitors. • Fetal- IUGR, fetal anomalies particularly of renal tract. Most commonly associated include bilateral renal agenesis, multicystic dysplastic kidneys, bladder outlet obstruction and infantile polycystic kidney disease. • Other factors noted to affect are maternal hydration and fetal presentation. • As per some reports Change of Breech to cephalic presentation has shown increase in AFI.
