Pregnancy Outcome in Hepatitis B and C Positive Mothers.

Abstract

Aims: To see frequency of hepatitis B and C in pregnant patient and the pregnancy outcome in hepatitis B and C positive mothers. Study design: descriptive study. Setting: This study was conducted in Gynae unit III and labour ward Nisbter hospital Multan from Jan 04 to Mar 05 in collaboration with Central Laboratory in our hospital. Material and methods: All pregnant patients admitted through OPD and labour ward who were found hepatitis B and C positive during screening were included in this study. Patient with chronic liver disease, cirrhosis and acute hepatitis due to A and E virus were excluded. A detailed history was taken followed by clinical examination. Routine investigation including liver function test and abdominopelvic ultrasound for fetal assessment and maternal liver status was done. Investigations were correlated clinically and physicians were involved accordingly. After delivery mother and baby were evaluated for any complication and babies of hepatitis B positive mothers were vaccinated. Results: Out of 1336 patients screened in 15 months of period, 135(10%) were hepatitis B positive, 89(6.6%) hepatitis C positive and 11 (.8%) were both hepatitis B and C positive. Past history of surgery was positive in 30 (15%), blood transfusion in 10 (5%), jaundice in 6 (3%) and I/v drug use in 2 (1%) patients. In current pregnancy 176 (88%) women were asymptomatic and 6(3%) developed jaundice, 12 (6%) had nausea and vomiting, 4 (2%) had fever and one patient presented with features of hepatic encephalopathy. Overall incidence of the hepatitis B and C was 17.5 % and no neonatal death was reported. Conclusion: This small hospital based study shows that HBV and HCV infections is quiet frequently seen in women of reproductive age however it does not adversely affect pregnancy outcome and pregnancy does not induce any detonation of liver disease. In a developing country like Pakistan it is an urgent need of the hour to create awareness amongst masses about safe sex, hazards of blood transfusion and I/v drug use. Information regarding incidence, prevalence and disease course of hepatitis and pregnancy still needs a lot of work.