Jaundice in pregnancy.

pregnancies. Pregnancy encompasses a wide variety of physiological changes with increased, decreased or unchanged parameters. Liver function abnormality can represent a physiological change, but elevations of transaminase, bilirubin, and prothrombin time almost always indicate a pathologic state. The major physiologic changes in pregnancy, that peak in second trimester and plateau at delivery, relating to liver functions are summarised in Table 1. Histology of the liver remains essentially normal during pregnancy. Lack of understanding of these changes can be misinterpreted as pathologic and can alter the criteria for diagnosis and therapy. The presenting clinical features of liver disease in pregnancy are often nonspecific and consist of jaundice, nausea, vomiting and abdominal pain. All liver diseases occurring during pregnancy can lead to increased maternal and foetal morbidity and mortality. Causes of Liver Disease and Jaundice in Pregnancy The jaundice can be classified in pregnancy on the basis of jaundice in existing liver disease, co-incidental liver disease and specific to pregnancy (Table 2). C H A P T E R