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Stable versus progressive hepatitis unique to pregnancy
Vivian Schutt1, Julia Uhanova, Carol Schneider
1Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
European Journal of Gastroenterology & Hepatology
|November 25, 2010
Summary
Mothers with hepatitis unique to pregnancy (HUP) and normal liver function tests can safely deliver at term. Standard liver function tests may help guide delivery timing for HUP patients.
Area of Science:
- Obstetrics and Gynecology
- Hepatology
- Neonatology
Background:
- Hepatitis unique to pregnancy (HUP) often necessitates urgent fetal delivery in the second or third trimester.
- The decision for early delivery in HUP is typically based on clinical urgency.
Purpose of the Study:
- To evaluate if standard liver function tests (serum bilirubin, international normalized ratio) can identify mothers with HUP and their neonates who would benefit from early delivery.
- To assess the impact of delivery timing on maternal and neonatal outcomes in HUP.
Main Methods:
- Retrospective analysis of 149 patients with HUP, classified into normal (stable-HUP, n=118) and abnormal (progressive-HUP, n=31) liver function test groups.
- Outcomes measured included maternal hospital stay post-delivery and neonatal Apgar scores at 0 and 5 minutes.
Main Results:
- Maternal hospital stay was similar for stable-HUP patients delivered early versus at term.
- Neonatal Apgar scores at birth were comparable between early and term delivery in stable-HUP, but significantly higher at 5 minutes for term deliveries.
- Insufficient data for term deliveries in the progressive-HUP group precluded similar comparisons.
Conclusions:
- Mothers with HUP and normal liver function tests can be managed expectantly until term without adverse effects on maternal or neonatal health.
- Further research is needed to establish whether abnormal liver function tests in HUP warrant immediate fetal delivery.
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