The HEV is an RNA virus that is enterically transmitted. It is widely distributed in the developing world, but rare in the United States. The clinical presentation of acute HEV hepatitis during pregnancy is that of liver failure, with high AT levels and increased prothrombin time. Acute HEV infection during the third trimester of pregnancy may result in up to 20% mortality caused by fulminant liver failure (3). It is believed that the fulminant course of HEV during pregnancy may result from some pregnancy-induced abnormality, perhaps some partial immunodeficiency, that alters the usually benign course of the infection in nonpregnant individuals. HEV infection has also been associated with reported cases of intrauterine deaths, but it is not clear whether this is related to maternal factors or direct fetal effects. Maternal-fetal transmission of HEV, resulting in neonatal symptomatic hepatitis, has been reported (4). There are no therapeutic agents currently available to prevent vertical transmission of the virus.
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