Figure 5.

Spontaneous Vaginal Delivery in pregnancy with HEV-ALF and the outcome on maternal disease. A 30-year-old pregnant woman presented with features of icteric hepatitis E virus infection. On the 24th day of her illness, she had rapid deterioration with encephalopathy, cerebral edema, and laboratory features of DIC. She delivered a live baby vaginally with icteric hepatitis E four days after the onset of encephalopathy. Serial follow-up showed rapid clinical improvement in encephalopathy, cerebral edema, and DIC. PSE = portosystemic encephalopathy, CE = cerebral edema, DIC = disseminated intravascular coagulation, RNA = HEV RNA, IgM = IgM anti-HEV, IgG = IgG anti-HEV.