Can Late Pregnancy Trigger Acute Hepatitis? Insights and Cases - Gastroenterology and Hepatology

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Acute hepatitis during late pregnancy is a serious condition that can pose significant risks to both the mother and the fetus. The possibility of developing acute hepatitis in the third trimester can arise from various factors, including viral infections, autoimmune conditions, and drug-induced liver injury.
1. Possibility of Acute Hepatitis in Late Pregnancy: While acute hepatitis is relatively rare in pregnancy, it can occur. One notable example is acute viral hepatitis, particularly hepatitis E, which has been associated with higher maternal and fetal morbidity and mortality. In some cases, pregnant women may present with symptoms such as jaundice, fatigue, and abdominal pain, which can lead to a diagnosis of acute hepatitis. A case reported in the literature described a pregnant woman in her third trimester who developed acute hepatitis E, resulting in severe liver failure and necessitating an emergency cesarean section. Unfortunately, despite medical intervention, both the mother and the infant faced dire outcomes.
2. Timing of Jaundice Appearance: In terms of the clinical course of acute hepatitis, the elevation of liver enzymes (GOT and GPT) typically precedes the onset of jaundice. In general, jaundice may become apparent several days to weeks after the liver enzymes begin to rise. For instance, in cases of acute hepatitis, the liver enzymes can peak within the first week of illness, while jaundice may not be evident until the second week. In your case, with GOT and GPT levels exceeding 1000, it is plausible that jaundice could have developed within a few days prior to the enzyme elevation, depending on the individual’s response to the liver injury.
3. Consultation with Hepatology Experts: For specialized medical advice, it is crucial to consult with a hepatologist or a gastroenterologist who has experience in managing liver diseases during pregnancy. Many academic medical centers have liver disease clinics that focus on such complex cases. You can reach out to local hospitals or medical schools to find specialists who can provide the necessary consultations. Additionally, organizations such as the American Association for the Study of Liver Diseases (AASLD) may offer resources and referrals to qualified professionals.

In summary, while acute hepatitis in late pregnancy is uncommon, it can occur and lead to severe complications. The timing of jaundice in relation to liver enzyme elevation is critical for understanding the progression of the disease. It is essential to seek expert medical advice for management and treatment options tailored to the specific circumstances of the patient. Early intervention and close monitoring are vital to improve outcomes for both the mother and the baby.