Jaundice in pregnancy

Abstract

<h2>Summary</h2> A review is given of the types of jaundice which occur in pregnancy. This is based on an analysis of 34 clinical cases with recovery and of 50 fa tal cases with autopsy. Vomiting of la te pregnancy may be caused by (a) infective hepa titis or its virulent form, true acute yellow atrophy, (b) "cholostatic hepa tosis," (c) the special type of acute hepa tic failure without massive necros.is which is known as obstetric acute yellow a trophy or fatty metamorphosis of the liver in pregnancy, (d) pyonephrosis or pyelonephritis, or (e) some idiopathic factor. Hyperemesis is not a cause of significant jaundice. There is no etiological relationship of gallstones to pregnancy, but pregnant patients may develop obstructive jaundice due to gallstones. Hemolytic jaundice occurs in about 10 percent of patients who die after eclampsia. It is also seen after incompatible transfusion and some abortions, and as a result of ordinary medical causes. Delayed chloroform poisoning is rare nowadays, but accounts for many of the cases of jaundice reported in the early literature. Sepsis is a rare cause of jaundice, and this only as a mild terminal condition. The other causes of jaundice in pregnancy are relatively unimportant. I have to thank many obstetric colleagues both in Glasgow and in Liverpool for the clinical records of these cases, and Dr. Crawford and Dr. Stewart who carried out many of the p athologic inv st iga tions. The clinical cases analyzed in this paper a re taken from the records of the Royal Maternity Hospital, Liverpool, and Mill Road Maternity Hospital, Liverpool , and from other hospitals in the region. Only a proportion of these p a ti ents have been seen by me personally. I am indebted to Drs. C. H. Walsh, P. Malpas, D. Prysor-Jones, A. G. Rickards, D. B. Mossman, H. H. Francis, and others for their help in connection with these cases.