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Jaundice is a condition that causes itching and yellowing of the skin, eyes, and mucous membranes. It happens when the liver does not function properly. Jaundice during pregnancy can be caused by pregnancy-related changes or it may just occur at the same time as pregnancy. Regardless of the cause, it can cause serious complications for mother and baby.
What causes jaundice?
Jaundice in pregnancy is rare, only occurring in 1 of every 1500 pregnancies. Jaundice occurs when a substance called bilirubin builds up in the blood. It is a naturally occurring compound in your body that is normally processed by the liver. The yellowing of the skin and eyes is the visible sign of the build-up of bilirubin and a signal that the liver isn’t operating like it should.
Common causes of jaundice during pregnancy include:
- Pre-eclampsia associated with HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets)
- Acute fatty liver of pregnancy
- Hyperemesis gravidarum
- Intrahepatic cholestasis of pregnancy
Other common causes not specific to pregnancy include:
- Hepatitis A, hepatitis B, hepatitis C, or hepatitis D
- Chronic liver disease
- Autoimmune hepatitis
- Drug-induced hepatitis
- Cirrhosis of the liver
Symptoms of jaundice
In addition to yellowing of the eyes and skin, jaundice also causes itching, dark-colored urine, light-colored stools, weakness, loss of appetite, headache, nausea and vomiting, fever, swelling of the abdominal area around the liver, and swelling of the legs, ankles, and feet. You may also notice red discoloration and bruises on the skin of the palms and the fingers, as well as small collections of blood vessels near the surface of the skin (called spider angiomas).
Signs and symptoms of jaundice are not very specific and may overlap with normal pregnancy changes, so laboratory tests are usually required for a definitive diagnosis and to identify the cause of the jaundice. Blood and urine tests to check for bilirubin levels, viral tests to check for infections, and liver enzyme tests to assess how the liver is functioning are common. An ultrasound may also check the size of the liver, and a liver biopsy may be required if these tests don’t determine the cause of the jaundice.
Is jaundice dangerous?
Jaundice during pregnancy means that the liver is not functioning properly and, without a well-functioning liver, the mother is at risk for neurological problems, kidney damage, and bleeding complications. Preterm delivery, stillbirth, placental abruption, and postpartum hemorrhage are also risk factors related to liver disorders during pregnancy. Newborns born to mothers with liver problems may experience growth restriction, congenital hepatitis, and neurological complications such as cerebral palsy.
Treatment for jaundice
Jaundice itself is not treated, per se, but, rather, the cause of the liver dysfunction should be addressed. In general, a low-protein diet and avoidance of food and drugs that may harm the liver are important measures for women with liver problems. Additionally, rest, hydration, and monitoring of blood pressure and urine output can help support women with liver problems. Depending on the severity of the jaundice, pregnant women may not require any other intervention than simple healthy practices and monitoring.
If the specific cause of the jaundice is identified, management may include antiviral medications, treatment for anemia, or even liver transplant. Any treatment chosen will depend on the cause of the jaundice and severity of the liver disease, as well as the mother’s overall health and the stage of pregnancy.
How to prevent jaundice
Like many other conditions, the best way to prevent jaundice is to consume a healthy diet and maintain a healthy bodyweight. Consuming excess fatty foods like dairy and meat may impair your liver, so be sure to eat these foods only in recommended quantities.
Stay up to date with vaccinations and ask your doctor if the hepatitis vaccine is right for you. Limit your use of medications, since some can cause liver damage. Always talk to your doctor or pharmacist when you start and stop any prescription or non-prescription medication to make sure you are taking the lowest effective dose for the shortest amount of time.
Wash your hands and be mindful of foods you eat to avoid possible infection with hepatitis viruses.
If you have already been diagnosed with a chronic liver disease before your pregnancy, talk to your doctor about what you can do to prevent complication and keep you and your baby healthy.