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Pregnancy-associated acute liver disease and acute viral hepatitis: differentiation, course and outcome.
J Hepatol. 2008 Dec; 49(6):930-5.JH

Abstract

BACKGROUND/AIMS

Pregnant women with acute viral hepatitis (VH) and those with pregnancy associated acute liver disease (PAALD) including acute fatty liver disease of pregnancy, hemolysis elevated liver enzyme and low platelet syndrome present with similar clinical features and liver tests abnormalities. Accurate differentiation between the two groups is critical to expedite early delivery in the latter and prevent progressive liver damage. There is scant data in the literature to differentiate between PAALD and VH.

METHODS

We studied the clinical variables, hematological, biochemical and viral serological tests of 87 consecutive pregnant patients with jaundice from 2000 to 2003.

RESULTS

There were 46 and 41 patients in PAALD and VH group, respectively. Two-thirds in VH group were due to hepatitis E. Univariate analysis identified hypertension, encephalopathy, oliguria, ascites, serum creatinine, and low platelets as significantly more common in the PAALD group. Multivariate analysis and recursive partitioning identified hypertension and ascites as predictors of PAALD with excellent predictive ability and c value of 0.92. Mortality was 41% in PAALD and 7.5% in VH. Increased bilirubin and oliguria were predictors of mortality in PAALD.

CONCLUSIONS

Presence of ascites and hypertension differentiates PAALD from VH and should prompt early delivery. Mortality due to hepatitis E is low.

Authors+Show Affiliations

Department of Gastroenterology, St. John's Medical College Hospital, Bangalore, India. harshad.devarbhavi@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18926590

Citation

Devarbhavi, Harshad, et al. "Pregnancy-associated Acute Liver Disease and Acute Viral Hepatitis: Differentiation, Course and Outcome." Journal of Hepatology, vol. 49, no. 6, 2008, pp. 930-5.
Devarbhavi H, Kremers WK, Dierkhising R, et al. Pregnancy-associated acute liver disease and acute viral hepatitis: differentiation, course and outcome. J Hepatol. 2008;49(6):930-5.
Devarbhavi, H., Kremers, W. K., Dierkhising, R., & Padmanabhan, L. (2008). Pregnancy-associated acute liver disease and acute viral hepatitis: differentiation, course and outcome. Journal of Hepatology, 49(6), 930-5. https://doi.org/10.1016/j.jhep.2008.07.030
Devarbhavi H, et al. Pregnancy-associated Acute Liver Disease and Acute Viral Hepatitis: Differentiation, Course and Outcome. J Hepatol. 2008;49(6):930-5. PubMed PMID: 18926590.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pregnancy-associated acute liver disease and acute viral hepatitis: differentiation, course and outcome. AU - Devarbhavi,Harshad, AU - Kremers,Walter K, AU - Dierkhising,Ross, AU - Padmanabhan,Lakshmi, Y1 - 2008/10/01/ PY - 2008/02/03/received PY - 2008/07/12/revised PY - 2008/07/22/accepted PY - 2008/10/18/pubmed PY - 2009/1/24/medline PY - 2008/10/18/entrez SP - 930 EP - 5 JF - Journal of hepatology JO - J Hepatol VL - 49 IS - 6 N2 - BACKGROUND/AIMS: Pregnant women with acute viral hepatitis (VH) and those with pregnancy associated acute liver disease (PAALD) including acute fatty liver disease of pregnancy, hemolysis elevated liver enzyme and low platelet syndrome present with similar clinical features and liver tests abnormalities. Accurate differentiation between the two groups is critical to expedite early delivery in the latter and prevent progressive liver damage. There is scant data in the literature to differentiate between PAALD and VH. METHODS: We studied the clinical variables, hematological, biochemical and viral serological tests of 87 consecutive pregnant patients with jaundice from 2000 to 2003. RESULTS: There were 46 and 41 patients in PAALD and VH group, respectively. Two-thirds in VH group were due to hepatitis E. Univariate analysis identified hypertension, encephalopathy, oliguria, ascites, serum creatinine, and low platelets as significantly more common in the PAALD group. Multivariate analysis and recursive partitioning identified hypertension and ascites as predictors of PAALD with excellent predictive ability and c value of 0.92. Mortality was 41% in PAALD and 7.5% in VH. Increased bilirubin and oliguria were predictors of mortality in PAALD. CONCLUSIONS: Presence of ascites and hypertension differentiates PAALD from VH and should prompt early delivery. Mortality due to hepatitis E is low. SN - 0168-8278 UR - https://www.unboundmedicine.com/medline/citation/18926590/Pregnancy_associated_acute_liver_disease_and_acute_viral_hepatitis:_differentiation_course_and_outcome_ DB - PRIME DP - Unbound Medicine ER -