Analysis of prognosis-associated factors in fulminant viral hepatitis during pregnancy in China.

OBJECTIVE

To analyze factors contributing to the prognosis of patients with fulminant viral hepatitis in pregnancy (FVHP).

METHODS

A retrospective study was conducted among 90 patients with FVHP who were admitted between January 1994 and August 2008 in 9 Chinese hospitals with expertise in the treatment of FVHP.

RESULTS

Different clinical types of FVHP presented with different fatality rates; the acute type showed the highest fatality rate and the chronic type showed the lowest fatality rate. Serum albumin (Alb), total cholesterol (Tch), total bilirubin (Tbil), prothrombin activity (PTA), creatinine (Scr), white blood cell count (WBC), the phenomenon of "bilirubin-transaminase separation", and intractable complications correlated with the prognosis of FVHP. The fatality rate increased with decreasing Tch and PTA, increasing WBC, the appearance of "bilirubin-transaminase separation", and complications such as hepatic encephalopathy, hepatorenal syndrome, hemorrhage, and infection. The above indices were all significantly different between survivor and non-survivor groups.

CONCLUSION

The clinical type of fulminant hepatitis, Alb, Tch, PTA, TBIL, Scr WBC, phenomenon of "bilirubin-transaminase separation", and intractable complications are important factors associated with prognosis of patients with FVHP. Dynamic monitoring of these indicators and active treatment of complications are key to the improvement of outcomes in patients with FVHP.