Question:medium
What is the most likely cause for a 26 year old pregnant woman from Bihar referred to a tertiary centre with hepatic encephalopathy?
What is the most likely cause for a 26 year old pregnant woman from Bihar referred to a tertiary centre with hepatic encephalopathy?
Show Hint
Think about which hepatitis virus is notorious for causing liver failure specifically in pregnant women.
Updated On: Jul 8, 2026
- HAV
- HBV
- HCV
- HEV
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Focus on the two big clues in the case.
The patient is pregnant, and she has hepatic encephalopathy, which means the liver has failed badly enough to affect the brain. This combination should immediately bring one virus to mind.
Step 2: Connect pregnancy with fulminant liver failure.
Among the hepatitis viruses, hepatitis E is the one specifically known to turn a routine feeling of illness into fulminant hepatic failure when it infects a pregnant woman, particularly later in pregnancy. The virus spreads through water contaminated with feces, which fits with an outbreak prone, poorly sanitized setting such as parts of Bihar.
Step 3: Check why the others do not fit as well.
HAV also spreads through contaminated food and water and can cause acute hepatitis, but it is not linked to this same sharp rise in fulminant failure during pregnancy. HBV is mainly a concern in pregnancy because the newborn can catch the infection at birth, not because the mother's liver suddenly fails. HCV typically causes a quiet, often unnoticed acute infection, with its main danger being chronic liver disease many years later, not a sudden crisis during pregnancy.
Step 4: Conclude.
The pattern of a pregnant patient from a region with unsafe water developing hepatic encephalopathy points to hepatitis E.
\[ \boxed{\text{HEV}} \]
The patient is pregnant, and she has hepatic encephalopathy, which means the liver has failed badly enough to affect the brain. This combination should immediately bring one virus to mind.
Step 2: Connect pregnancy with fulminant liver failure.
Among the hepatitis viruses, hepatitis E is the one specifically known to turn a routine feeling of illness into fulminant hepatic failure when it infects a pregnant woman, particularly later in pregnancy. The virus spreads through water contaminated with feces, which fits with an outbreak prone, poorly sanitized setting such as parts of Bihar.
Step 3: Check why the others do not fit as well.
HAV also spreads through contaminated food and water and can cause acute hepatitis, but it is not linked to this same sharp rise in fulminant failure during pregnancy. HBV is mainly a concern in pregnancy because the newborn can catch the infection at birth, not because the mother's liver suddenly fails. HCV typically causes a quiet, often unnoticed acute infection, with its main danger being chronic liver disease many years later, not a sudden crisis during pregnancy.
Step 4: Conclude.
The pattern of a pregnant patient from a region with unsafe water developing hepatic encephalopathy points to hepatitis E.
\[ \boxed{\text{HEV}} \]
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