A prospective study on pregnancy complicated with jaundice with special emphasis on fetomaternal outcome

Abstract

Background: Jaundice defined as yellow discolouration of skin, sclera and mucus membrane resulting from increased serum bilirubin concentration. It is usually clinical visible when plasma bilirubin exceeds 3mg/dl. This study aimed at determining maternal and foetal outcome in women with jaundice complicating pregnancy.Methods: This prospective study was conducted on 58 cases of pregnant women with jaundice (serum bilirubin ≥3 mg%) admitted at Panna Dhaya Zanana Hospital (PDZH), RNT Medical College, Udaipur, Rajasthan from January 2016 December 2016.Results: The incidence observed in this study was 0.28%. 77.59% cases in this study were in third trimester of pregnancy. Serum bilirubin was >20 mg% in 5.18% cases. Haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, acute fatty liver of pregnancy, intrahepatic cholestasis of pregnancy, viral hepatitis and malaria were the causes of jaundice. HELLP syndrome was the most common cause of jaundice. Of 58 women 38 delivered vaginally and 12 were LSCS for obstetrical indication and 8 were undelivered. The disease is associated with high incidence of preterm labour, IUGR, birth asphyxia and foetal distress. Perinatal mortality was 38%. Maternal mortality in 11 cases i.e. 18.96%. Main causes of maternal mortality were hepatic encephalopathy, DIC followed by shock due to PPH, DIC followed by multiple organ dysfunction syndrome.Conclusion: Jaundice and pregnancy having a grave prognosis, resulting in a very high perinatal as well as maternal morbidity and mortality, and requires an early diagnosis and careful management.