What is the cause of high total bilirubin during pregnancy?

During pregnancy, women's endocrine system will be disrupted. Due to the stimulation of estrogen and progesterone, various hormones in the body will be high. Total bilirubin is a hormone related to the human liver. There is a mutual influence between it and the liver. Liver-related diseases or bile stasis will indirectly stimulate its content to increase. There are four main reasons for high total bilirubin during pregnancy.

1 Physiological reasons

After a woman becomes pregnant, her body's metabolism increases and the liver's burden increases. Sometimes it is difficult for the liver to completely convert indirect bilirubin into direct bilirubin and excrete it from the body, causing some of the indirect bilirubin to flow back into the blood, resulting in a slightly high level of total bilirubin. This is a normal physiological phenomenon and there is no need to worry.

2 Cholestatic syndrome

High total bilirubin in pregnant women is likely caused by cholestasis syndrome. However, when an expectant mother suffers from cholestasis, bilirubin may reflux into the blood through the hepatic sinusoids and be carried throughout the body of the pregnant woman and fetus through the blood circulation. However, when the bilirubin concentration reaches a certain value, the excessive bilirubin will pass through the blood-brain barrier and cause kernicterus.

3. Liver disease

When pregnant women suffer from diseases such as acute icteric hepatitis, acute yellow liver necrosis, chronic active hepatitis, and cirrhosis, their total bilirubin may also be high. This is because the disease damages liver cells, causing excessive production of indirect bilirubin, which the liver cannot completely convert into direct bilirubin, resulting in high total bilirubin.

4 Extrahepatic diseases

Pregnant women with extrahepatic diseases, such as hemolytic jaundice, blood transfusion reactions due to blood type incompatibility, cholecystitis, cholelithiasis, etc., may also have high total bilirubin. Because when tumors or stones occur in the extrahepatic biliary system, the bile duct will be blocked, making it impossible for bile to be excreted smoothly, resulting in symptoms of high total bilirubin.