Elevated bilirubin during pregnancy
Hyperbilirubinemia (excess of normal values of bilirubin in the blood) in pregnant women is quite common, with a frequency of 1:1500. The reasons can be a pathology of pregnancy-related diseases of pregnant women. For each pathology clinical management of pregnancy and childbirth is different. In any case, the woman should be examined carefully, otherwise the jaundice and elevated bilirubin will bring unpleasant symptoms and complications.
What are the possible causes of high bilirubin levels during pregnancy?
One of the most frequent and obvious manifestations of hyperbilirubinemia is jaundice (staining of the skin and sometimes mucous membranes in yellowish color). The most frequent reasons that cause jaundice in pregnant women are liver disease (called hepatic types jaundice). Also, there are obstructive or obstructive jaundice (the reason is when you exit from the liver in the bile ducts) and suprarenal (their cause is the abnormal metabolism of bilirubin to the liver, for example, reinforced the breakdown of hemoglobin in the blood in hemolytic anemia). According to another classification, all pregnant hyperbilirubinemia can be divided into 2 large groups:
Description of jaundice in pregnant women
As already mentioned, jaundice is always associated with the fact that in the blood of pregnant elevated bilirubin. To determine the amount of this pigment will help in the biochemical analysis of blood. There are several fractions of this pigment, the ratio of which can be put the diagnosis.
- Cholestatic hepatosis of pregnant women. Until now, the cause of this pathology is not fully understood. It is believed that produced in pregnancy hormones lead to the stagnation of bile (cholestasis), this reaction is due to a genetic predisposition of the woman’s body. This pathology occurs most often to the 3rd trimester, increasing to childbirth and completely goes away after. Accompanied by pruritus, then attaches jaundice, but it can not be.
- Fatty liver in pregnant women is a very rare disease called Sheehan’s syndrome. The symptoms are characterized by acute onset with abdominal pain and vomiting, then attaches jaundice, fever, stomach and uterine bleeding. If time does not diagnose this condition, a high probability of death in the fetus and the mother. The only option is emergency cesarean delivery, after birth, the disease gradually fades away.
- Jaundice (hyperbilirubinemia) in the background of toxemia. When toxicosis occur vascular disorders that lead to microvascular complications (damage to small blood vessels of the liver) and the appearance of clots in the sinuses of the liver. Thus the clinically combined symptoms of toxicity and hepatitis (abdominal pain, nausea, repeated vomiting, DIC). A serious complication of this condition may be the formation of hematoma under the capsule of the liver, rupture and the occurrence of intra-abdominal bleeding.
- Jaundice extreme vomiting during pregnancy occurs because of metabolic disorders in the liver, dehydration, women and protein fasting.
- Viral hepatitis are among the most frequent causes of jaundice in pregnant women (almost half of all jaundice). Abortion or premature birth weight for hepatitis, so treatment of pregnant aims to alleviate the condition and prolong the pregnancy until term delivery.
- Chronic liver disease can manifest as jaundice, itching of skin before pregnancy, but can manifest during it. Increased symptoms in pregnancy is associated with the action of estrogen.
- Obstructive jaundice in pregnant women most often develops as a result of blockage of the bile duct stone, rarely tumor. A special feature of pregnancy is that bile becomes more viscous, difficult its outflow from the gallbladder, there is often the formation of stones in bladder in pregnancy. The clinical manifestation of the pathology begins with pain in the right hypochondrium, fever and often vomiting.
- The suprarenal jaundice are common in pregnant women. They are caused by hemolytic anemia. In confirmation of the diagnosis is the presence of reduced hemoglobin and red blood cells, increase deconjugating bilirubin (indirect his faction), feces and dark color.