Jaundice is caused when the liver does not function properly. The most visible symptom of jaundice is the yellowish discolouration of the sclera of the eyes, skin and urine. Liver disease during pregnancy includes a spectrum of diseases, which may occur during pregnancy and the postpartum period that result in abnormal liver function tests, hepatic and biliary system dysfunction, or sometimes both. It is observed in 3 to 10% of all pregnancies.
Following are the common signs & symptoms of the underlying liver disease:
Diagnosing liver disease during pregnancy can be challenging and depends on laboratory investigations. Signs and symptoms are mostly not very specific and can include vomiting, and pain in the stomach. The causative disease of jaundice can have a significant effect on the outcomes in both, the mother and the baby, and requires a battery of tests to be run. Here are the main ways in which jaundice is diagnosed:
his may show skin changes, such as redness of palms of hands and cherry-like skin lesions. These changes occur due to high levels of oestrogen in pregnant women and occur in about 60% of healthy pregnancies.
Lab tests that show a low level of albumin (a plasma protein) in serum, elevated ALP or alkaline phosphatase, and elevated prothrombin time (PT) indicates a problem.
Ultrasonography is the first choice, since it is free of radiation risk to the foetus. Magnetic resonance imaging (MRI) may also be used. It is relatively safer than computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP), which are more specific diagnostic tools but involve a risk of radiation hazard for the baby.
The effects on foetus because of jaundice in pregnancy are many. Risks include maternal and delivery-related problems as well as the direct impact on the foetus.
Maternal health risks include fulminant (severe impairment of liver function) or severe hepatitis (if not treated), hepatic encephalopathy (a neurological complication of severe liver damage), liver damage induced kidney problems like hepatorenal syndrome, liver Cirrhosis, abnormal bleedings like haemorrhagic varies, and a risk of liver malignancy in a few cases.
Delivery related complications include preterm deliveries, stillbirths, abruption placenta and postpartum haemorrhages, and risk of transmission of infections in the newborn during delivery.
Risks to the newborn include IUGR (intrauterine growth restriction), congenital hepatitis and neurological complications including kernicterus (brain damage in a newborn due to jaundice) and cerebral palsy in severe cases.
Treatment of jaundice during pregnancy is based on the causative factor and is majorly dependent on the time of recognition of the symptoms and the stage of pregnancy.
Common lines of treatment, irrespective of the cause of jaundice, include,
Specific management of jaundice depends upon the underlying conditions:
You must consume fatty products like dairy foods and meat only in the recommended quantities, as excessive consumption may further affect your liver.
Maintain a healthy weight and regulate cholesterol levels in the blood
Hepatitis can be prevented with effective vaccination. Your gynaecologist will advise you about it
Avoid taking drugs or compounds that can be toxic to the liver. You should ask your doctor before popping any pills during pregnancy, as these can be harmful to your baby
Avoid travelling to regions that have a breakout of diseases like malaria. The malarial parasite destroys red blood cells, and this may lead to jaundice.
Go for regular checkups. Seek medical help as soon as you notice symptoms of jaundice to avail early treatment and to ensure a speedy recovery. Jaundice during pregnancy can be managed when diagnosed in time.
You may also consider some home remedies for the treatment of jaundice during pregnancy. These are not medically proven, but you can try them in addition to your treatment for a faster recovery.
Liver disease during pregnancy could be a mild disease with very few symptoms even if you have an abnormal liver function report. The issue may be resolved on its own, or it may develop into a potentially serious condition affecting your liver. It may even lead to permanent liver damage. Viral hepatitis infection is the most common reason for pregnancy jaundice. It is usually mild to moderate disease. Active treatment may not be needed except in hepatitis E and HSV infections.
Early detection of liver diseases in pregnancy, and an integrated approach by the treating gynaecologist, gastro physician, hepatologist and transplant specialist can help you manage the condition safely.