A comprehensive study on jaundice in pregnancy with emphasis on fetomaternal outcome

ABSTRACT

Background: Jaundice affects a small percentage (1-4 per 1000) of pregnant women, yet it is an important medical disorder especially in developing countries like India. Jaundice in pregnancy carries adverse outcomes for both the fetus and the mother. It accounts for 60% perinatal and 14% of maternal deaths. The aim of the study is to know the incidence of jaundice, to evaluate the causes of jaundice and to know the effect of jaundice during pregnancy on maternal and fetal outcome. Materials and methods: All pregnant women with jaundice admitted in the Department of Obstetrics and Gynecology, King George Hospital, Visakhapatnam between September 2015 and August 2017 were taken up for study. Results: The incidence of jaundice was 7.22 per 1000 deliveries. Since 92.54% of patients were between 20-35 years of age, maximum number of cases was Primi gravidae. The most common cause of jaundice was HELLP syndrome, hepatitis being the second most common cause. Maternal mortality was 12.74%, the perinatal mortality was 35.71%, prematurity being the commonest cause. Conclusions: Jaundice in pregnancy has adverse fetomaternal outcome. It should be managed as a team in collaboration of obstetrician, physician, gastroenterologist, anesthetist and neonatologist. Improvement in health education, regular antenatal check-ups and early referrals result in early diagnosis and treatment of jaundice during pregnancy thus reducing maternal and fetal morbidity and mortality.