Influenza A hepatitis in pregnancy

Influenza A has been described in association with hepatitis. We present a case of complicated influenza A hepatitis in a pregnant woman, adding to the broad differential of liver disease in pregnancy.

A 32-year-old woman, gravida 3 para 2002, at 31 4/7 weeks of gestation had influenza A diagnosed and subsequent development of severe pruritis and elevated liver enzymes (aspartate aminotransferase 659 international units/L, normal 15-46 micromoles/L; alanine aminotransferase 933 international units/L, normal 13-69 micromoles/L; and total bile acids 249.7 micromoles/L, normal 4.5-19.2 micromoles/L). She was treated supportively, and fetal surveillance was normal. Her symptoms resolved over the subsequent 2 weeks, and she delivered a healthy term newborn.

Influenza A infection can be associated with hepatitis in pregnancy, which in our case resolved spontaneously over 10 to 14 days with favorable maternal and perinatal outcomes.