Jaundice in pregnancy becomes detectable as visible yellow coloration of skin, sclerae and mucosa when plasma bilirubin rises above 2mg./100 ml(normal range 0.2-0.8 mg./100ml.).
The causes of jaundice in pregnancy can be grouped as follows:
Viral hepatitis:
(i) Infected hepatitis is caused by virus type A from infected person or carrier through contaminated food and water. This is the common cause of jaundice in pregnancy in many countries, and forms an important cause of maternal death due to ‘Associated Causes’. Maternal undernutrition predisposes the condition. There is centrilobular zonal necrosis of liver and intrahepatic cholestasis. Thus there are hepatocellular jaundice with intrahepatic obstructive jaundice. In majority cases complete regeneration of hepatic cells occur. Rarely acute hepatic necrosis and coma may develop. Pregnant woman is not more susceptible to this viral hepatitis.
(ii) Serum hepatitis type B is caused by transfusion of blood, pooled dried plasma or from needle prick of a syringe used on an infected person. Australia antigen is closely associated with serum hepatitis.
(iii) Gall stone: This is a rare cause of jaundice in pregnancy. This jaundice is obstructive type.
(iv) Hepatotoxic drugs: Chlorpromazine may cause jaundice by intrahepatic cholestasis in susceptible woman. Large doses of tetracycline can cause acute fatty liver during pregnancy.
(v) Haemolytic jaundice: Mismatched blood transfusion, cl. Welchii infection, congenital spherocytosis.
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