Jaundice in pregnancy

A report describes a case of a 28-year-old primigravida with 35 weeks of gestation who presented with severe nausea, vomiting, and considerable fatigue five days before her hospital visit. 

An ultrasound, taken two weeks before her hospital visit, revealed normal physiological changes. At the time, the liver and kidney scans were normal. However, the patient had low liquor, and her AFI was 3 cm. 

Clinical examination revealed pedal edema and icterus with elevated blood pressure. During this visit, her AFI was only 1-2 cm, indicating severe oligohydramnios.

An abdominal scan revealed a slightly enlarged liver with fatty changes. Laboratory investigations reported dimorphic RBCs with marked anisopoikilocytosis, leukocytosis, and abnormal liver and renal function tests, as well as altered lipid profile. 

The patient was euglycemic, but her blood pressure at admission was 140/80 mmHg. The patient had a very low Bishop’s score of 3 and thus was planned for emergency lower segment cesarean section (LSCS), which was performed without any complications.

The patient’s lab values right after delivery revealed altered LFTs, altered RFTs, anemia, and coagulopathy. She also showed an abnormal lipid profile with severely low HDL levels, increased VLDL levels, and a high cholesterol-to-HDL ratio.

George M, Parikh P, Chandekar A, Meghani P, Jaundice in pregnancy and its causes: A case report. Indian J ObstetGynecol Res. 2023;10(1):70-74