INTRODUCTION:
Jaundice in pregnancy, whilst relatively rare, has potentially serious consequences for maternal and fetal health. It can be caused by pregnancy or occur intercurrently. It is responsible for 10% of maternal deaths. The incidence of Jaundice in India varies from 0.4 to 0.9 per 1000 deliveries. Acute vital Hepatitis is the most common cause of Jaundice in pregnancy.
Jaundice is a clinical term referring to the yellowish discoloration of Sclera, Mucous Membrane and Skin caused by the accumulation of bilirubin in body fluids.
Jaundice is clinically detectable when the serum bilirubin concentration exceeds 2.5 mg per dl in the body fluids
AIMS AND OBJECTIVES:
1. To analyze the maternal outcome in terms of mode of termination of pregnancy, maternal morbidity and mortality in jaundice complicating pregnancy.
2. To identify the relation of maternal morbidity and mortality in relation to admission serum bilirubin level.
3. To assess fetal outcome by perinatal mortality and morbidity.
4. To identify the various etiologies and distribution of jaundice with reference to age, parity and trimesters.
METHODOLOGY:
This is a prospective observational study in The Institute of Obstetrics and Gynaecology from January 2018 to February 2019.
79 pregnant women admitted with Jaundice to Government Women and Children Hospital, IOG, were studied in detail. All relevant history were taken in detail in a pre-designed proforma. They were examined in detail. The results were marked in a master chart and the results were analysed.
OBSERVATION:
◈ Of the 79 women studied,maximum (n=44,55.7 %) were in the 21-25 years age group followed by 22.8% in 26-30 years age group,15.2% in 18-20 years age group,3.8 % in 31-35 years age group and 2.5% in > 35 years age group.
◈ Of the 79 women studied 57% were multiparous women and the rest 43% were Primi women.
◈ High coloured urine was the most common symptom seen in 44.3% of the women. Second common symptoms were fever and Nausea & vomiting (40.9% each). Other common symptoms in decreasing order of frequency were loss of appetite (37.4%), upper abdominal (12.2%), pruritis and clay coloured stools.
◈ Icterus was the most commonly elicited sign(60.9 %) followed by hepatomegaly (16.5 %), splenomegaly (6.1%), Scratch marks (3.5%) and ascites (0.9%).
◈ Out of the 79 patients, 40.5% had complications: Complications were Anemia (25.4%), pre-eclampsia (7.6%), hepatorenal failure (5.1%), Hemetemesis and encephalopathy (3.8% each).
◈ The duration of symptoms were mostly between 6-10 days (53.2%) followed by less than 5 days (35.4%), 11-30 days (6.3%) and > 30 days (5.1%).
CONCLUSION:
The development of jaundice during pregnancy is an important health hazard and needs careful monitoring during antepartum, peripartum and postpartum period. As prevention is better than cure, primary prevention by various health programmes and health education to pregnant women will help to live in a healthy environment. This can be achieved with the help of paramedical staff and mass media. At the secondary and tertiary level a team work by obstetricians, gastroenterologist, neurologist, nephrologists,
microbiologist will help to achieve good outcome in jaundiced patients during antenatal, perinatal and neonatal period
