Maternal and fetal outcomes of jaundice in pregnancy at the University College Hospital, Ibadan.

OBJECTIVE

This study is aimed at determining pregnancy outcome of cases of jaundice in pregnancy over a 10 year period at the University College Hospital, Ibadan.

METHODOLOGY: All case records of patients with jaundice in pregnancy over a 10-year period from 1st January 1992 through 31st December 2001 were retrieved from the medical records office of the hospital and analysed.

RESULTS

During the ten-year study period, there were 16,566 registered pregnancies in the hospital, and 52 cases of jaundice in pregnancy were seen, giving an overall incidence of 0.3% or 1 in 318 deliveries. However, 48 case records were retrievable. Viral hepatitis was the commonest cause accounting for 58.3% of cases. It was followed by malaria and sickle-cell anaemia with 20.8% and 16.7% respectively. Other causes include sepsis 14.6%, cholestasis 6.3%, and Pre-eclampsia 2.1%. Preterm delivery occurred in 39.6%, while intrauterine fetal death (IUFD) occurred in 8.3% of cases, all occurring in the third trimester. A case of early neonatal death was recorded. There was no maternal death and the mean hospital stay was 18 days (range 4-45 days) during admission.

CONCLUSION

Viral hepatitis, malaria and sickle-cell anaemia are the leading causes of jaundice in pregnancy. These should be promptly diagnosed, investigated and appropriate management instituted as most of the perinatal deaths can be avoided by close fetal monitoring especially in the third trimester and with recourse to early delivery before fetal demise occurs.