Maternal and fetal outcome in jaundice complicating pregnancy

Abstract

Background: The incidence of jaundice in India varies from 0.4 to 0.9/1000 deliveries. Jaundice in pregnancy carries a grave prognosis for both the mother and the fetus, and is responsible for 10% of maternal deaths. Liver disease in pregnancy is an important medical disorder seen more often in developing countries than in developed ones. The present study analyzes the causes and the fetomaternal outcome in pregnancies affected with jaundice.Aim: 1. To analyze the maternal outcome in terms of mode of termination of pregnancy, maternal complications and mortality of jaundice complicating pregnancy. 2. To identify the relation of maternal morbidity and mortality in relation to admission serum bilirubin level. 3. To assess fetal outcome by perinatal mortality and morbidity. 4. To identify the various etiologies and distribution of jaundice with reference to age, parity and trimesters. Subjects and Methods: Fifty women with jaundice complicating pregnancy admitted and treated at Government Kilpauk Medical College Hospital, Chennai from September 2017 to August 2018 were studied. A detailed history including patient’s age, socioeconomic status, booking, parity and details of menstrual history to arrive at the expected date of delivery was obtained. Patients were enquired in detail about their complaints and duration like nausea, vomiting, pruritus, anorexia, yellow coloured urine, pale stools, edema legs, bleeding tendency, joint pain, fever and others. Past history of jaundice especially in previous pregnancy and history of blood transfusion were elicited. Results: The incidence of jaundice in India varies from 0.4 to 0.9/1000 deliveries. According to this study incidence is 2/1OOO deliveries. Singh reported 1.03/1000 incidence while Kamalajayaram and Rama Devi reported 0.4/1000 incidence. Conclusion: According to this study the initial bilirubin level at admission > 10 is associated with poor maternal outcome and high maternal mortality.