Jaundice in pregnant women
When one thinks of jaundice, the first thing that comes to mind is babies who sometimes get that yellow colour after being born.
However, little is said about the jaundice that can affect the mother during and after pregnancy.
According to Dr Ryan Halsall, obstetrician-gynaecologist, it isn’t a very common condition, but when it does happen, the outcome can be devastating to both mother and baby.
“To say the least, jaundice and pregnancy just don’t mix,” he said. “Jaundice is usually caused by either an increased breakdown of red blood cells as is seen in patients with sickle cell disease, or from liver damage. So jaundice may be caused by things completely unrelated to pregnancy such as hepatitis and gallstones.”
Moreover, there are a few pregnancy-specific disorders that can lead to jaundice. These include:
1. Hyperemesis gravidarum
Dr Halsall said in the early stages of pregnancy, excessive vomiting may lead to severe dehydration. “In this case the dehydration is so bad that it affects liver function, leading to jaundice. Luckily, prompt rehydration can restore function and allow the jaundice to resolve,” he said.
2. HELLP Syndrome
“This is a severe complication of the hypertensive condition pre-eclampsia, which occurs after the first half of pregnancy. It stands for hemolysis, elevated liver enzymes and low platlets, which is essentially a complicated way of saying the ‘pressure’ problem is gone past severe. At this stage only delivery can save either mother or baby,” Dr Halsall said.
3. Acute fatty liver
Dr Halsall said this one occurs later down in the pregnancy, and is more common in first-time mothers and those who have twin pregnancies. “As the name suggests, there is a sudden build-up of fatty acids in the liver, which causes severe liver dysfunction and subsequent jaundice,” Dr Halsall said. “The risk of death to mother and baby is high — almost 20 per cent of mothers die who have this condition, and up to 70 per cent of babies. Again, here, delivery is the best option for survival.”
Dr Halsall said luckily most of these complications are rare in pregnancy, but if for any reason you are pregnant and notice yellowing of your eyes and skin see your doctor right away. “Don’t wait, not even until the next day,” he said.
–Kimberley Hibbert
