Management of Severe Hepatitis E Infection in Pregnancy: Assessing Early Delivery as a Safe and Effective Intervention for Improving Maternal and Neonatal Outcomes
1Khizar Hayat, 2Husnain Haider, 3Dr Nighat Saleem, 4Raja Assad Tariq, 5Zulqarnain Agha, 6Dr Uzair Butt
- PIMS, Islamabad
- PIMS, Islamabad
- AJKMC Mzd
- Poonch medical college Rawalakot
- UHS
- Ayub medical college Abbottbad
Vol: 16/03
Received: January 025, 2026 Accepted: March 22, 2026 Published: June 16, 2026
Abstract
Background: There have been reports that around 70% of pregnant women who have acute hepatitis E quickly progress to acute liver failure with a short period of pre-encephalopathy. Acute liver failure presents with decreased synthesis of proteins from the liver causing coagulopathy, encephalopathy and other neurological complications.
Objective: Comparison of maternal and fetal outcomes in pregnant females with moderate and severe
hepatitis E infection
Materials and Methods: The approval from institutional review board of ethics was taken for this study. This prospective study was done in collaboration with Department of Gastroenterology and Department of Gynaecology, Fatima Memorial Hospital, Lahore for a period of 1year from 2020-2021. All pregnant females with serologically detected Hepatitis E.Pregnant females with deranged liver function tests with other causes than Hepatitis E Pregnancy related liver diseases.
Results: 87 patients were enrolled in the study. At the time of diagnosis, the patients in the first trimester were 7%, in the second trimester were 23% and in the third trimester were 57%. The patients below 30yrs of age were 77 patients (88.5%) while more than 30yrs old were 10 patients (11.5%). These patients were grouped according to severity of disease, which showed that 47 patients (54%) patients had severe liver disease due to hepatitis E as compared to 40 patients (46%) who had moderate disease. Majority of the patients with severe disease were in their third trimester of gestation.
Conclusion: Although there are no guidelines for management of pregnant patients with HEV infection, however if early delivery of the fetus is possible to prevent maternal mortality, it should be tried. Further randomized controlled studies are needed to decide the best way of managing these patients with HEV infection in pregnancy.
Keywords: Severe Hepatitis E, Pregnancy, Early Delivery, Safe and Effective, Treatment Option.