ABSTRACT

Aim: To determine the fetomaternal outcome after early induction of labor in pregnant women with hepatitis E induced acute liver failure.

Design: This was a descriptive case series.

Methods: It was conducted at the Department of Obstetrics and Gynecology, Mayo Hospital Lahore over 2 years from January 2019 to December 2020. 40 consecutive pregnant women aged between 18-40 years presenting with fulminant hepatic failure due to hepatitis E infection during 3rd trimester of gestation were included after written informed consent. These patients were managed by early induction of labor. Fetomaternal outcome was noted in terms of need for cesarean delivery, postpartum hemorrhage, maternal death and intrauterine.

Results: In the present study, the mean age of the study participants was 25.5±4.4 years while the mean gestational age was 33.4±2.2 weeks. There were 11 (27.5%) primiparas and 29 (72.5%) multiparas. We observed that early induction of labor significantly improved fetomaternal outcome evident from decreased frequency of Cesarean delivery (30.0%), postpartum hemorrhage (7.5%), maternal death (17.5%) and intrauterine (10.0%) and early neonatal death (5.0%).

Conclusion: In the present study, early labor induction in pregnant women with hepatitis E induced acute liver failure significantly improved the fetomaternal outcome which thus advocates it to be preferred approach in the management of such women in future obstetric practice.

Keywords: Hepatitis E, Pregnancy, Fulminant Hepatic Failure, Early Labor Induction