Hepatitis means inflammation of the liver. It may occur without symptoms, although jaundice is the major manifestation of hepatitis. In jaundice, the serum bilirubin (liver enzyme) level increases beyond 2 mg % causing yellow discoloration of the skin, mucous membrane and conjunctiva of eyes along with decreased appetite, fatigue, and weakness.
The causes of Hepatitis (Jaundice) during pregnancy are classified as-
- Hepatitis or jaundice due to pregnancy
- Hepatitis or jaundice not related to pregnancy
Hepatitis or Jaundice due to pregnancy
The reasons are
- Intrahepatic cholestasis: The second most common cause of jaundice in pregnancy Caused due to excess circulation of estrogen leading to stasis of bile into bile canaliculi. It usually occurs in the last trimester of pregnancy and may appear in subsequent pregnancies also. Generalized pruritus or whole body itching is the most common symptom. It may be associated with weakness, nausea and sometimes vomiting. Blood investigation shows little or no rise in bilirubin level but the other enzymes SGOT and serum alkaline phosphatase levels are elevated
- Severe pre-eclampsia
- Acute fatty liver
- Endogenic shock
Hepatitis not related to pregnancy
The reasons are
- Viral hepatitis– The most common cause of hepatitis during pregnancy. Types of viral hepatitis- Hepatitis A, B, C, D, and E. Hepatitis A and E are mainly caused by drinking infected water or food products contamination Hepatitis B, C and D are mainly caused through intravenous route or contact with body fluids, blood transfusion or sexual contact. In hepatitis B and D, there is a possibility of vertical transmission from mother to baby. We have seen rising trends of HCV in more and more pregnant women, because of the sharp rise in prescription drug abuse.
- Hemolytic jaundice– Caused due to transfusion of mismatched blood
- Jaundice due to gall bladder stones– Caused due to obstruction of the bile duct due to gall stones
- Drug-induced– Certain drugs like acetaminophen cause jaundice
Effect of hepatitis on mother and baby
For mother, there is an increased risk of postdelivery heavy bleeding (PPH postpartum hemorrhage), hemorrhagic manifestations and hepatic coma.
For baby, risk of abortion and premature delivery risk is higher
How can we prevent hepatitis?
- Taking care of personal hygiene
- Using disposable syringes and needles
- Eating properly cooked food
- Vaccines as per the advice of the doctor
Simple precautions can make a great difference. Our expert team of Gynecologist & Gastroenterologist can manage viral hepatitis in pregnancy after assessing the risk of transmission to the baby, mother’s risk of decompensation, and understanding the side effects of antiviral drugs.