الفهرس | Only 14 pages are availabe for public view |
Abstract The incidence of Jaundice is rare during pregnancy. Jaundice may result from common hepatic disorders or from conditions unique to pregnancy. Viral hepatitis is the most common cause of jaundice during pregnancy. Another rare causes related to pregnancy are hyperemesis gravid arum at early pregnancy while liver diseases of late pregnancy are acute fatty liver of pregnancy, intrahepatic cholestasis of pregnancy, toxaemia of pregnancy and the HELP syndrome. The aim of the present work was to study jaundice among pregnant women in Alexandria at Alexandria fever hospital and Shatby University Hospital for Gynaecology and Obstetrics, over one year (1 st January - 31 st December 2005) it included 20 patients. The study revealed the following results: 1- Acute hepatitis A was reported in 55% of all admitted cases. Acute HB infection was detected in 10%, chronic of He in 10%, acute HE infection in 5%, Hyperemesis gravidarum in 5%, pre-eclampsia of pregnancy 5%, cholestasis of pregnancy 5% and HELP syndrome in 5% of cases. 2- Jaundice in pregnancy was found to affect young age groups 20-30 years (80%) while 20% of cases were older age groups >30 years: two cases of chronic C, one case of pre-eclampsia of pregnancy, also one case of HELP syndrome. 3- Most of the admitted cases of jaundice in pregnancy were admitted at Alexandria fever hospital (85%). 4- There was an equal number of cases from urban and rural areas (50% each). 5- Low and low middle social score cases represented most of the studied cases (70%). 6- Most of the studied cases presented with yellowish discolouration of sclera, dark urine and abdominal pain (95%, 90% and 75% respectively, followed by malaise, clay stool and headache (65%, 45% and 20%) respectively. 7- Most cases presented with acute onset (70%), regressive course (75%), 20% with stationary course and one case with progressive course (5%). 8- It was found that 65% of cases were at the 2nd and 3rd trimester, only 35% at 1 st trimester. 9- Most of the cases were with a normal weight to gestation (75%) while increasedweight and weight loss were 10%, 15% respectively. 10- Only one case (5%) received hepatotoxic drugs ”rifampicin” as she suffered from U.T.!. at 1 st trimester before diagnosing pregnancy. 11- Most cases were taking drugs during pregnancy: antipyretics, antiemetics, antibiotics and antihypertensives (55%, 50%, 15%, 5% respectively). 12- Most of the reported cases did not have a history of previous jaundice (95%) and 85% of cases had no history of chronic diseases. 13- Risk factors were found in 60% of the reported cases (30% dental manipulation, 20% surgical interference and 10% blood transfusion). 14- Family history of jaundice was found in only 20% of the studied cases. 15- 80% of cases did not have any history of abortion, As regards gravida sequence: Primi, 2nd gravida, 3rd gravida, 4th gravida were 40%, 30%, 15%, 15% respectively. 16- Hepatomegaly occurred in 90% of cases, splenomegaly 40%, ascites 5% and occult oedema 5%. 17- Serum bilirubin: Less than 5 mgldl at 65% of cases while 35% of cases were 5 mgldl or above. 18- Serum level of ALT and AST were: 40-<100 iu/ml: 50%, 80% respectively. 100-<200 iu/ml: 25%, 15% respectively. > 200 ill: 25%, 5% respectively 19- Alkaline phosphatase level was raised in 80% of the studied cases. 20- 55% of cases had anaemia, while only 5% ”one case” had thrombocytopenia. 21- It was found that 20% of cases was related aetiologically to the pregnancy state. |