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article i nfo Objective: To investigate maternal and perinatal outcomes in cases of fulminant viral hepatitis in late preg- nancy (FVHILP). Methods: A multicenter retrospective study was conducted. The records of 40 patients with FVHILP were retrieved from 3 hospitals in China. To analyze the influence of mode of delivery on mater- nal and perinatal outcomes, women were allocated to the cesarean delivery group or the spontaneous vaginal delivery (SVD) group. To study the relationship between maternal outcome and perinatal outcome, patients were allocated to the maternal survival group or the non-survival group. Results: There were no significant differences between the cesarean group and the SVD group in clinical manifestations or laboratory indices before delivery, or in fatality rate (P>0.05 for all), whereas there were significant differences in newborn weight, 1-minute Apgar score, and incidence of severe perinatal asphyxia between the maternal survival group and the non-survival group (Pb0.05 for all). Conclusion: Maternal and perinatal outcomes in cases of FVHILP were not influenced by mode of delivery, whereas perinatal outcome significantly correlated with maternal outcome.

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.