Bonney Joseph Humphrey Kofi, Kwame-Aryee Robert A, Obed Samuel, Tamatey Ama Asantewa, Barnor Jacob Samson, Armah Naa Baake, Oppong Samuel Antwi, Osei-Kwesi Mubarak
Noguchi Memorial Institute for Medical Research, School of health Sciences, University of Ghana, Accra, Ghana.
BMC Res Notes. 2012 Sep 3;5:478. doi: 10.1186/1756-0500-5-478.
Viral infections during pregnancy can pose serious threats to mother and fetus from the time of conception to the time of delivery. These lead to congenital defects, spontaneous abortion and even death. The definitive diagnosis and management of pregnancy-related viral infections may be challenging especially in less resourced countries.
We present clinical and laboratory responses to the diagnosis and management of three cases of fulminant hepatitis secondary to Hepatitis E viral infection in pregnancy.Case 1 was a 31-year-old Ghanaian woman who presented with a week's history of passing dark urine as well as yellowish discoloration of the eyes. She subsequently developed fulminant hepatitis secondary to Hepatitis E viral infection, spontaneously aborted at 24 weeks of gestation and later died.Case 2 was also a 31-year-old Ghanaian woman who was admitted with a four-day history of jaundice. She had low grade fever, but no history of abdominal pain, haematuria, pale stool or pruritus. She next developed fulminant hepatitis secondary to Hepatitis E viral infection. However, she did not miscarry but died at 28 weeks of gestation.Case 3 was a 17-year-old Ghanaian woman who was referred to the tertiary health facility on account of jaundice and anaemia. She had delivered a live male infant at maturity of 32 weeks but noticed she was jaundiced and had a presentation of active disease 3 days prior to delivery. The baby was icteric at birth and on evaluation, had elevated bilirubin (mixed type) with normal liver enzymes. Hepatitis E virus infection was confirmed in both mother and baby. However, the jaundice and the hepatomegaly resolved in mother and baby after 5 and 12 days respectively.
To the best of our knowledge, these are the first documented cases of fatal fulminant hepatic failures resulting from HEV infection in Ghana.
从受孕到分娩期间，孕期病毒感染会对母亲和胎儿构成严重威胁。这些感染会导致先天性缺陷、自然流产甚至死亡。对于与妊娠相关的病毒感染，尤其是在资源匮乏的国家，明确诊断和管理可能具有挑战性。
我们介绍了三例妊娠合并戊型肝炎病毒感染继发暴发性肝炎的诊断和管理的临床及实验室反应。病例1是一名31岁的加纳妇女，有一周排深色尿液及眼睛发黄的病史。她随后继发戊型肝炎病毒感染导致暴发性肝炎，在妊娠24周时自然流产，随后死亡。病例2也是一名31岁的加纳妇女，因黄疸病史4天入院。她有低热，但无腹痛、血尿、浅色粪便或瘙痒史。她随后继发戊型肝炎病毒感染导致暴发性肝炎。然而，她没有流产，但在妊娠28周时死亡。病例3是一名17岁的加纳妇女，因黄疸和贫血被转诊至三级医疗机构。她在32周足月时产下一名活男婴，但在分娩前3天注意到自己黄疸且有活动性疾病表现。婴儿出生时黄疸，经评估，胆红素升高（混合型），肝酶正常。母亲和婴儿均确诊为戊型肝炎病毒感染。然而，母亲和婴儿的黄疸和肝肿大分别在5天和12天后消退。
据我们所知，这些是加纳首例记录在案的由戊型肝炎病毒感染导致的致命性暴发性肝衰竭病例。
