A 32-year-old pregnant woman (28 weeks gestation) presents with fever, jaundice, and coagulopathy. She belongs to a rural area with recent flooding. AST/ALT are markedly elevated. The diagnosis MOST consistent with high mortality in pregnancy is:

• A Hepatitis A
• B Hepatitis B
• C Hepatitis C
• D Hepatitis E ✓

Explanation

Hepatitis E virus (HEV), transmitted by the fecal-oral route and linked to contaminated water during floods, causes case fatality rates of 15-25% in pregnant women (especially in third trimester), compared to <1% in non-pregnant individuals. This is attributed to immunological changes in pregnancy and fulminant hepatic failure. Hepatitis A also spreads fecal-orally but has low mortality in pregnancy; Hepatitis B is parenterally transmitted.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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