The effect of MELD scoring system for predicting the short-term prognosis of pregnancy complicating fulminant hepatitis

DENG Liu-zhi; LI Xiao-mao; CHEN Dun-jin; YU Yan-hong; TANG Xiao-ping; ZHAO Shao-fei; TAN Hua-lin

Abstract：Objective To investigate the value of model of end-stage liver disease (MELD) scoring for predicting the short-term prognosis of pregnancy complicating fulminant hepatitis. Methods MELD scores of 66 patients with pregnancy complicating fulminant hepatitis on admission were calculated, so did the MELD scores and their differences (AMELD)of 26 late pregnancy patients underwent cesarean section and 5 late pregnancy patients underwent vaginal de livery before and after operation/delivery. The relationship between MELD scores or AMELD and prognosis was analyzed. Concordance (c) -statistic was used to evaluate the predicting ability of MELD scoring system for the prognosis of preg nancy complicating fulminant hepatitis. Results MELD scores of 66 patients on admission of death group were higher than those of survival group( P <0.01); MELD scores of 31 late pregnancy patients delivered in hospital were compared between survival group and death group before operation/delivery, the difference was significant; MELD scores of 26 pa tients underwent cesarean section were decreased gradually in survival group after operation, while the MELD scores of death group were increased gradually, the difference of MELD scores between these two groups before and after operation was significant. The difference between preoperative MELD scores and MELD scores three days after operation was signif icant between survival group and death group. c-statistics were all more than 0. 8. Conclusions MELD scoring system shows extraordinary predicting value for the short-term prognosis of pregnancy complicating fulminant hepatitis. The differ ence between preoperative MELD scores and MELD scores three days after operation also shows good predicting value.