Jaundice occurring in pregnancy may be a sign or symptom of a severe disease and should not be underestimated.

CAUSES

1. Obstetric

• Severe pre-eclampsia/eclampsia/HELLP Syndrome (Haemolysis, Elevated Liver enzymes, Low Platelets syndrome)

• Severe hyperemesis gravidarum

• Cholestatic jaundice of pregnancy

• Acute Fatty Liver of pregnancy

2. Non-obstetric

• Viral hepatitis

• Haemolytic jaundice - malaria, sickle cell disease, G6PD defect, septicaemia

• Surgical causes of jaundice - acute cholecystitis, cholelithiasis, obstructive jaundice

INVESTIGATIONS

• FBC, Blood film for malaria parasites, sickling status
• G6PD status
• Liver function tests
• Hepatitis B surface antigen
• Abdominal ultrasound scan with emphasis on the hepato-biliary system and pancreas

TREATMENT

Depends on the underlying cause

REFER

Severe cases of jaundice and those associated with abdominal pain must be referred to a physician specialist.