alexa Obstetrical Management of Fulminant Viral Hepatitis in
ISSN: 2161-038X

Reproductive System & Sexual Disorders: Current Research
Open Access

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Review Article

Obstetrical Management of Fulminant Viral Hepatitis in Late Pregnancy

Zhongjie Shi1,2*, Xiaomao Li1, Yuebo Yang1, Lin Ma1,3 and Ann Schreiber3

1Department of Obstetrics and Gynecology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, People’s Republic of China

2Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA

3Health Science Center, Temple University, Philadelphia, PA 19140, USA

*Corresponding Author:
Zhongjie Shi
Department of Cancer Biology
Thomas Jefferson University
519 Bluemle Life Science Building. 233 S 10th St
Philadelphia, PA 19107, USA
Tel: 1-215-204-9999
E-mail: [email protected]

Received date: August 22, 2011; Accepted date: January 05, 2012; Published date: January 07, 2012

Citation: Shi Z, Li X, Yang Y, Ma L, Schreiber A (2012) Obstetrical Management of Fulminant Viral Hepatitis in Late Pregnancy. Reproductive Sys Sexual Disord 1:102. doi:10.4172/2161-038X.1000102

Copyright: © 2012 Shi Z, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Objective: To set up a routine perinatal treatment guideline for fulminant viral hepatitis in late pregnancy (FVHLP). Method: A summary of literature of successful treatment at various clinical stages. Due to the limited number of prospective studies, retrospective, observational studies and case reports were analyzed and pathophysiological mechanisms were summarized as well. Results: A comprehensive obstetrical treatment guideline was proposed as follows: (a) Awareness of FVHLP should be reinforced among medical staff; (b) Patients diagnosed with FVHLP should be transported to regional expert centers before labor onset; (c) Supportive medication should be administered to prepare the patients for incoming delivery. A central venous line should be maintained to provide rapid intravenous access and monitor central venous pressure before operation start; (d) Caesarean section is recommended for the mode of delivery, followed by peripartum hysterectomy to control postpartum hemorrhage; (e) Peritoneal/abdominal lavage and drainage tube placement are recommended following operation to decrease abdominal pressure and detect post-operational bleeding; (f) Hypertonic glucose along with insulin topical injection is recommended to promote the healing of wound; (g) Supportive medication, replenishment of coagulation factors, preventive antibiotics should be given as needed. Adjust the amount and order of intravenous fluid according to the character and amount of drainage and urine. Conclusion: Vital obstetrical measures taken include supportive treatments, delivery at appropriate time by cesarean section, and prevent and control of various complications. Guidelines developed with more robust research are still needed

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