Late pregnancy urinary jaundice and abnormal liver function

Late pregnancy yellow urine accompanied by abnormal liver function may be related to factors such as intrahepatic cholestasis of pregnancy, viral hepatitis, acute fatty liver during pregnancy, drug-induced liver injury, and cholestatic liver disease. It is recommended that pregnant women seek medical attention in a timely manner to check liver function, bile acid and other indicators, and receive targeted treatment after identifying the cause.

1. Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy is a unique complication of late pregnancy, mainly characterized by skin itching, yellow urine, and abnormal liver function. This disease is related to elevated estrogen levels leading to bile excretion disorders, which may cause premature birth or fetal distress. Diagnosis requires monitoring of serum bile acid levels. Mild symptoms can be relieved by ursodeoxycholic acid, and in severe cases, early termination of pregnancy is necessary. Pregnant women should avoid high-fat diets and undergo regular fetal heart monitoring.

2. Viral hepatitis

Viral infections such as hepatitis B and hepatitis E can lead to abnormal liver function in late pregnancy. Viral hepatitis is often accompanied by symptoms such as fatigue and decreased appetite, in addition to yellow urine. Hepatitis E poses a greater threat to pregnant women. Diagnosis should be confirmed through hepatitis virus marker testing, and antiviral treatment should be administered if necessary. Newborns should be vaccinated with hepatitis B vaccine and immunoglobulin in a timely manner after birth, and doctors should be consulted before breastfeeding to assess the risk of infection.

3. Acute fatty liver during pregnancy

Acute fatty liver during pregnancy is a life-threatening emergency that often occurs in the late stages of pregnancy, characterized by yellow urine, nausea and vomiting, and rapid deterioration of liver function. The disease is related to abnormal fatty acid metabolism in the fetus and requires immediate hospitalization. The condition should be stabilized through supportive treatments such as plasma exchange. Once diagnosed, pregnancy should be terminated as soon as possible. Pregnant women need to closely monitor their coagulation function, as postpartum liver function can gradually recover.

4. Drug induced liver injury

Some pregnant women may experience drug-induced liver injury due to taking iron supplements, antibiotics, or traditional Chinese medicine. Symptoms include yellow urine and elevated transaminase levels after medication, which often recover on their own after discontinuation. Medication in late pregnancy should strictly follow medical advice and avoid self medication that may harm the liver. If abnormalities occur, medication should be stopped in a timely manner and liver function should be tested. If necessary, liver protective drugs such as compound glycyrrhizin should be used as adjuvant therapy.

5. Cholestasis induced liver disease

Chronic liver diseases such as primary biliary cholangitis may worsen during pregnancy, leading to increased jaundice in urine and abnormal liver function. This type of disease is usually accompanied by symptoms such as skin itching and persistent jaundice, and needs to be diagnosed through autoantibody testing. The main treatment during pregnancy is ursodeoxycholic acid, and in severe cases, caution should be exercised when using glucocorticoids. Long term follow-up of liver function is necessary after childbirth to avoid disease progression to cirrhosis. When yellow urine and abnormal liver function occur in late pregnancy, pregnant women should maintain sufficient rest and drink no less than 2000 milliliters of water per day to aid metabolism. Choose low-fat and high protein foods such as fish and tofu for diet, and avoid animal organs and fried foods. Regularly check liver function indicators and fetal condition. If there is worsening skin itching, dark urine color like strong tea, or abnormal fetal movement, seek medical attention immediately. Liver function should be rechecked 42 days after delivery, and medication during lactation should strictly follow the guidance of liver disease specialists and obstetricians.