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Hepatitis E in pregnancy.

OBJECTIVES: To study the spectrum and the clinical and biochemical course of viral hepatitis E during pregnancy.

METHODS: In this prospective study, sera of 62 pregnant women having jaundice in the third trimester of pregnancy were analyzed for markers of hepatitis A, B, C and E viruses. The cord blood samples of hepatitis E virus (HEV)-positive pregnant women at the time of delivery were tested for IgM anti-HEV antibodies by enzyme-linked immunosorbent assay and HEV-RNA by reverse transcriptase polymerase chain reaction.

RESULTS: Of the 62 patients, 45.2% had HEV infection and nine developed fulminant hepatic failure (FHF). Eighty-one percent of FHF cases and 37.25% of acute viral hepatitis cases were caused by HEV. Approximately two-thirds of the pregnant women with HEV infection had preterm deliveries. The mortality rate among the HEV-positive pregnant women was 26.9%. Vertical transmission was observed in 33.3% of cases.

CONCLUSIONS: One-third of the pregnant women with HEV infection had a severe form of hepatitis in the third trimester of pregnancy, i.e. FHF. Hepatitis E in pregnancy is associated with high rates of preterm labor and mortality.

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