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 19 January 2018

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News

Pregnancy as a prognostic indicator in acute liver failure

The most recent issue of Hepatology reports on 20-year observations of acute liver failure during pregnancy.

News image

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Pregnant patients with acute liver failure are believed to have a worse outcome than nonpregnant women and men with acute liver failure.

However, objective data supporting this supposition are scant.

Dr Vikram Bhatia and colleagues from India compared the outcome, complications, and causes of acute liver failure among pregnant females with age-matched nonpregnant males and females with acute liver failure.

The team evaluated 1015 consecutive acute liver failure patients in the reproductive age group admitted between 1986 and 2006.

A total of 249 women were pregnant.

They were compared with 341 nonpregnant women and girls and 425 men and boys, aged 15 to 45 years.

The team found that the mortality rate of pregnant women and girls was similar to age-matched nonpregnant women and girls, and men and boys.

Mortality in Hep E virus-acute liver failure in pregnant women and girls was 51%
Hepatology

The clinical and biochemical features, disease severity, and complications were also similar in the 3 groups.

The researchers noted that 59% of acute liver failure cases were attributable to Hepatitis E virus among women and girls who were pregnant.

Amongst nonpregnant women and girls, 30% of acute liver failure cases, and 23% in men and boys were attributable to Hepatitis E.

The team found, however, that the outcome of Hepatitis E virus-related acute liver failure was independent of the sex and pregnancy status of the patients.

Mortality in Hepatitis E virus-acute liver failure and non-Hepatitis E virus-acute liver failure patients in pregnant women and girls was 51% and 55%, respectively.

The outcome of pregnant acute liver failure patients was also unrelated to the trimester of pregnancy.

The mortality of non-Hepatitis E virus-related acute liver failure among the pregnant women and girls was 55%.

The researchers observed that mortality among age-matched nonpregnant women and girls was 62%, and 63% in men and boys.

Dr Bhatia’s team concluded, “The mortality of pregnant patients with acute liver failure is similar to that of nonpregnant women and girls and men and boys, and is independent of the cause or trimester.”

“Pregnancy per se should not be regarded as a poor prognostic factor for a patient with acute liver failure.”

Hepatol 2008: 48(5): 1577-85


03 November 2008

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