Evaluation of the prognosis of fulminant viral hepatitis in late pregnancy by the MELD scoring system

Abstract

The purpose of this paper was to analyze the prognosis of women with fulminant viral hepatitis in late pregnancy (FVHILP) by the Model for End-Stage Liver Disease (MELD) scoring system. A retrospective study involving patients admitted to two tertiary hospitals between January 1, 1994 and June 30, 2011 was undertaken. The relations between MELD scores and change of MELD score over time (ΔMELD) and prognosis during hospitalization were analyzed. Among the 54 patients with FVHILP, the MELD scores on admission were significantly higher in the non-survival group than those in the survival group (p < 0.05). Among the 26 FVHILP patients who underwent cesarean section, the MELD scores before and after cesarean section were both significantly higher in the non-survival group (p < 0.05). The ΔMELD scores (before operation and three days after operation) significantly increased in the non-survival group (p < 0.05). The concordance (c-statistic) values were all greater than 0.8. The MELD scoring system shows excellent short-term predictive value for the prognosis of FVHILP.

American Gastroenterological Association Institute Technical Review on Initial Testing and Management of Acute Liver Disease

“…We identified 6 studies [79][80][81]83,86,87 evaluating 526 ALF patients and, overall, 304 (58%) died. All studies did not have liver transplantation available so this eliminates bias owing to competing outcomes but the samples were not representative of Western populations (causes of ALF and management will be different).…”

Maternal and perinatal outcome in cases of fulminant viral hepatitis in late pregnancy

“…In previous studies [1,10] based on 1-way analysis of variance in the prognosis of FVHILP, it was found that Tch, PTA, Scr, WBC, and the presence of 3 or more intractable complications were important factors influencing patient prognosis. The MELD scoring system is also effective at evaluating the prognosis of FVHILP [21]. In the present study, blood test results and the occurrence of major complications showed that pre-delivery maternal conditions were similar between the SVD group and the cesarean group.…”

Mother-to-child transmission of HBV: review of current clinical management and prevention strategies

“…In summary, preventive strategies of HBV MTCT have evolved from routine schedules after delivery to medication during pregnancy and delivery. Although the results of many of the trials have not yet been integrated into national or international guidelines, with the development of novel techniques, drugs, and additional large‐scale clinical trials (Figure ), the problem of MTCT of HBV may be minimized, and millions of children of HBV‐carrying mothers will enjoy a better life, free of potential liver disease .…”