The virus which can cause fulminant hepatitis in pregnant women inducing a mortality rate of 20% is?

MNS 2024

Obstetrics & Gynaecology

Easy

Appeared in: MNS 2024

Explanation

Hepatitis E virus (HEV) infection during pregnancy is associated with a significantly increased risk of developing fulminant hepatitis, which is acute liver failure.
The mortality rate from HEV-induced fulminant hepatitis in pregnant women, particularly in the third trimester, is approximately 20%.
HEV is primarily transmitted through the fecal-oral route, often via contaminated water supplies in endemic areas.
While the disease is typically mild and self-limiting in the general population, pregnancy is a major risk factor for a severe outcome.

Option A: Hepatitis A rarely causes fulminant hepatitis, and its mortality rate is very low (less than 0.5%). It does not pose a specific high-mortality threat to pregnant women.
Option B: The primary concern with Hepatitis B in pregnancy is the high risk of vertical (mother-to-child) transmission. The rate of fulminant hepatitis is much lower (around 1-2%) and not specifically elevated to 20% in pregnancy.
Option C: Hepatitis D is a defective virus that can only infect individuals who are already infected with Hepatitis B. While co-infection can be severe, it is not the specific virus known for causing a 20% mortality rate in pregnant women on its own.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of viral hepatitis in pregnancy as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in preventing HEV by educating pregnant women on hygiene and the importance of consuming safe drinking water, especially when traveling to or living in endemic regions.
A pregnant woman presenting with jaundice requires urgent evaluation. If Hepatitis E is suspected or confirmed, she must be monitored closely in a hospital setting for signs of acute liver failure, such as encephalopathy or coagulopathy.
What if? If the patient was a non-pregnant 30-year-old male, a Hepatitis E infection would most likely present as a mild, self-limiting acute hepatitis with a very low mortality rate (less than 1%), and he would likely recover fully without hospitalization.

How to Approach the Question

First, identify the key clinical details in the question stem: a virus causing 'fulminant hepatitis' specifically in 'pregnant women' with a high 'mortality rate of 20%'.
Next, review the options, which are different types of hepatitis viruses.
Systematically recall or deduce the primary characteristics of each virus in the context of pregnancy.
Eliminate Hepatitis A, as it is generally mild with very low mortality.
Eliminate Hepatitis B, recognizing its main pregnancy-related risk is vertical transmission, not a 20% maternal mortality rate.
Eliminate Hepatitis D, as it is a co-infection dependent on HBV.

Concept Tested & Keywords

Concept Tested: Complications of viral hepatitis in pregnancy
Stem keywords: virus, fulminant hepatitis, pregnant women, mortality rate, 20%
Lead-in keywords: is
Clinical cues: The combination of 'pregnant women' and '20% mortality' is a classic indicator for Hepatitis E.
Negative lead-in flag: false

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