Jaundice in Pregnancy - Causes, Symptoms and Treatment

During the later stages of pregnancy, the liver is affected by an increase in placental hormones, leading to changes in its function. These changes include an increased ability to store bile and a reduction in the speed of bile movement, which slows down the liver's metabolism. 

If the liver is not functioning correctly, it can accumulate bilirubin in the bloodstream. Bilirubin is a yellow pigment formed from the breakdown of old red blood cells and is usually processed by the liver and excreted through the bile ducts. When the liver cannot perform this function properly, bilirubin levels rise, leading to a condition known as jaundice.

Jaundice during pregnancy may occur due to various causes. Some of these potential causes of jaundice in pregnancy include the following,

1. Viral hepatitis: The most common reason for jaundice in pregnancy is acute viral hepatitis, which can be caused by different viruses such as hepatitis A, B, C, and D. These viruses usually do not cause serious harm to the pregnant woman or the baby. However, hepatitis E can cause more severe symptoms and complications during pregnancy.
2. Autoimmune hepatitis: Jaundice in pregnancy may occur due to autoimmune hepatitis. It is a condition in which the immune system attacks the liver, causing inflammation and damage to this vital organ. This disorder is usually chronic, meaning it lasts a long time. It is characterized by elevated levels of certain proteins in the blood and the presence of autoantibodies.
3. Hemolysis: Jaundice in pregnancy can also be caused by hemolysis, a condition where red blood cells break down faster than the body can replace them. Hemolysis can occur due to various underlying conditions, including sickle cell disease, thalassemia, and Rh incompatibility between the mother and the baby. 
4. Cholestasis: Another reason for jaundice during pregnancy may be due to cholestasis. In the later stages, women may develop a liver condition known as cholestasis of pregnancy, also called intrahepatic cholestasis of pregnancy. Jaundice in pregnancy may be a symptom of cholestasis. 
5. Preeclampsia: Preeclampsia is a severe medical condition related to blood pressure during pregnancy. Individuals with preeclampsia usually experience hypertension, characterized by high blood pressure (BP) and proteinuria, an excessive amount of protein in the urine.
   1. Typically, preeclampsia emerges after the 20th week of pregnancy and can harm other organs in the body, posing a risk to both the mother and the developing fetus.Jaundice during pregnancy may occur due to preeclampsia.
6. Liver cirrhosis: Experiencing jaundice in pregnancy may result from liver cirrhosis. This is a chronic condition where liver fibrosis, or scarring, of the liver, occurs over time. This scarring can lead to the shrinkage of the liver and, eventually, liver failure.
7. Acute fatty liver during pregnancy: It is a rare but severe and serious complication that can occur during pregnancy, usually in the third trimester. It is characterized by the accumulation of fat in the liver, which can cause liver failure, jaundice, and other complications. 
8. Hyperemesis gravidarum: Another cause of jaundice in pregnancy may include Hyperemesis gravidarum. It is a condition that can cause mild elevation of bilirubin levels and liver enzyme levels.

Since jaundice in pregnancy is a rare occurrence, it is important to be aware of its symptoms. This is because jaundice can cause potential harm to the baby and mother if not treated on time. The various symptoms of jaundice during pregnancy include the following,

1. Yellowing of the skin and eyes
2. Dark urine
3. Light-colored stools
4. Itching all over the body
5. Nausea and vomiting
6. Abdominal pain
7. Headache 
8. Liver swelling
9. Fatigue and weakness
10. Loss of appetite
11. Fever
12. Swelling in the ankle, feet, and legs

Upon experiencing the symptoms that may indicate jaundice, it is important to consult a doctor immediately. The doctor upon suspecting jaundice, will recommend several diagnostic tests to confirm the condition and begin the treatment. The various tests that may be performed by the doctor to diagnose jaundice include the following, 

1. Physical examination: In a physical examination, the doctor will check the symptoms of the patient such as, yellow discoloration on the skin, eyes and mucous membranes, fever, mental confusion, etc. 
2. Blood tests: Upon physical examination, the doctor will prescribe blood tests to confirm jaundice. Blood tests can help determine the levels of bilirubin, liver enzymes, and other chemicals in the blood, which may indicate liver function and any abnormalities. 
3. Imaging tests: Imaging tests such as ultrasound scan may be done to check for any liver abnormalities, gallstones, or other issues that could be causing jaundice. An ultrasound may also help in viewing how severe the liver damage is.

The treatment of jaundice during pregnancy will depend on the underlying cause. The goal of treatment is to control the condition, avoid any potential medical complications, and address the root cause of the problem. The various treatment options available for treating jaundice during pregnancy may include the following, 

1. Management of underlying conditions: If jaundice is caused by an underlying condition such as obstetric cholestasis or hepatitis, treating the condition can help resolve jaundice.
2. Medications: Medications may be prescribed to treat the underlying cause of jaundice, such as antibiotics for an infection or medication to control bile acid levels in obstetric cholestasis. 
3. Phototherapy: In some cases, phototherapy, which uses special lights to break down bilirubin in the blood, may be used to treat jaundice.
4. Supportive care: This includes measures to manage symptoms, such as anti-itch or anti-nausea medication.

Although jaundice in pregnancy is usually mild and can be treated effectively, it can lead to unfavorable outcomes for both the mother and the baby in certain cases. Conditions like preeclampsia and other medical illnesses can be associated with severe liver damage and complications.

The severity of liver damage can determine the degree of risk for the mother and the baby. Therefore, prompt medical attention and treatment are critical to minimize the risk of adverse outcomes.

Risks for Mother 

There are several potential complications for the mother with jaundice during pregnancy. These complications in mothers with jaundice during pregnancy may include, 

1. Chronic damage to the liver 
2. The bleeding tendency as a result of the failure of coagulation
3. Neurological complications
4. Hepatic encephalopathy that may cause brain function failure 
5. Renal shutdown

Risks for Baby

Jaundice in pregnancy may pose risks to the baby as well. These risks and complications in the baby due to jaundice during pregnancy may include the following, 

1. The baby being born early or too small due to premature labour
2. Stillbirth or death of the baby while in the womb
3. Transmission of infections from the mother to the baby
4. Neonatal jaundice 
5. Increased risk of cerebral palsy 
6. Inadequate oxygenation and growth

Following certain precautionary measures to prevent its development is essential to avoid jaundice during pregnancy. These include:

1. Get vaccinated for Hepatitis B and C viruses. 
2. Avoid eating food that may be contaminated, such as roadside or street food.
3. Maintain an ideal body mass index (BMI) to prevent the risk of a fatty liver. 
4. Avoid self-medications to prevent hepatotoxicity.
5. Staying hydrated by drinking a lot of water and fluids can help flush toxins from the body and support overall health.
6. Manage any existing medical conditions that may increase the risk of jaundice during pregnancy, such as hepatitis.
7. Avoid alcohol consumption and drug abuse.
8. Maintain a healthy diet to support liver function and reduce the risk of liver damage.
9. Get regular checkups done and follow the instructions of your healthcare provider. 

If a pregnant woman develops jaundice, following a healthy and balanced diet that supports liver function and overall health is essential. Some dietary recommendations that may help during jaundice in pregnancy include:

Foods to Eat

Foods that are to be included in the diet during jaundice in pregnancy include the following,

1. Fruits and vegetables, such as, berries, kiwi, papaya, grapes, tomatoes, carrots, cauliflower, broccoli, spinach, avocados, etc. 
2. Whole grains, like oats, quinoa, rice, and millets.
3. Legumes, including kidney beans, peas, etc
4. Nuts, such as, walnuts, almonds, hazelnuts, etc

Foods to Avoid

Foods that are to be avoided in the diet during jaundice in pregnancy include the following,

1. Packaged food
2. Sugary foods 
3. Foods containing excessive amounts of sodium 
4. Fat foods
5. Alcohol

Jaundice during pregnancy can be a serious condition and should be evaluated by a doctor promptly if any symptoms of jaundice are observed during pregnancy. Some signs that may indicate jaundice during pregnancy include:

1. Yellowing of the skin and eyes
2. Dark urine
3. Pale stools
4. Fatigue or weakness
5. Nausea or vomiting
6. Abdominal pain or discomfort
7. Loss of appetite

Jaundice during pregnancy may occur due to various causes, including viral hepatitis, autoimmune hepatitis, hemolysis, cholestasis, preeclampsia, liver cirrhosis, acute fatty liver of pregnancy, and hyperemesis gravidarum. 

Treatment for jaundice in pregnancy will depend on the underlying cause. It may include managing underlying conditions, medication, delivery of the baby, and supportive care such as hydration, nutrition, and monitoring of liver function. When experiencing jaundice during pregnancy, it is essential to seek medical attention promptly.

At HexaHealth, we understand the importance of providing quality healthcare services at an affordable cost. We offer the best affordable services for jaundice in pregnancy, a condition that can be dangerous if left untreated. At HexaHealth, we have a team of experienced doctors and medical staff dedicated to ensuring our patients' well-being. Our pregnancy care services are also top-notch, providing expecting mothers with the necessary support and care during this critical time.