Journal of Case Reports in Medical Science

Especially in the third trimester, hepatitis E virus (HEV) infection is a major threat in pregnancy and the likelihood of maternal death can be as high as 20-30 %. There is a higher susceptibility of pregnant women to severe hepatic damage because of immunity and the changes in hormones that might contribute to increased viral replication. In this case report, a 27-year-old female patient at 30 weeks of gestational age presented with a history of acute jaundice, loss of strength and increased liver enzymes. Anti-HEV IgM positivity was proved by serological and HEV RNA was found by polymerase chain reaction, which confirmed the diagnosis of acute HEV infection. The patient was admitted to maternal-fetal close and frequent monitoring after the diagnosis which involved serial liver functioning tests, coagulation studies and the fetal surveillance. Supportive treatment in the form of hydration, rest and watching of any possible complications like fulminant hepatic failure or coagulopathy was initiated. This condition slowly got better and fetal analysis was normal throughout hospitalization. The case highlights the limitations in diagnosis of differentiating between HEV infection and other liver disorders in pregnancy and the need to identify and diagnose them early, conduct lab tests, and use multidisciplinary support services. Timely treatment has great potential to enhance the results in pregnant women with acute infections of HEV.