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| WHEN JAUNDICE DEVELOP DURING PREGNANCY |
Jaundice is yellowish discoloration of the skin, sclera and mucous membranes due to hyper bilirubinemia and deposition of bile pigments.
Most of the diseases discussed previously can affect women during pregnancy, but there are some additional causes of jaundice that are unique to pregnancy.
CHOLESTASIS OF PREGNANCY
Cholestasis of pregnancy is an uncommon condition that occurs in pregnant women during the third trimester. The cholestasis often is accompanied by itching but infrequently causes jaundice. The itching can be severe, but can be treated with drugs (ursodeoxycholic acid or ursodiol [Actigall, Urso]).
There also is an association between cholestasis of pregnancy and cholestasis caused by oral estrogens, and it has been hypothesized that it is the increased estrogens during pregnancy that are responsible for the cholestasis of pregnancy.
PRE ECLAMPSIA
Pre-eclampsia, previously called toxemia of pregnancy, is a disease that occurs during the second half of pregnancy and involves several systems within the body, including the liver. It may result in high blood pressure, fluid retention, and damage to the kidneys as well as anemia and reduced numbers of platelets (thrombocytopenia) due to destruction of red blood cells and platelets. It often causes problems in the fetus. Although the bilirubin level in the blood is elevated in pre-eclampsia, it usually is mildly elevated, and jaundice is uncommon.
ACUTE FATTY LIVER OF PREGNANCY
Acute fatty liver of pregnancy (AFLP) is a very serious complication of pregnancy. The cause of AFLP is unclear, but is often associated with pre-eclampsia. It occurs late in pregnancy and results in failure of the liver. It can almost always be reversed by immediate delivery of the fetus. There is an increased risk of infant death. Jaundice is common, but is not always present in AFLP.
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