Pregnancy with gilbert syndrome - a case report

Area of Science:

• Obstetrics and Gynecology
• Hepatology
• Clinical Genetics

Background:

• Gilbert syndrome is a common, benign genetic disorder characterized by reduced activity of Uridine diphosphate glucuronosyl transferase (UDPGT).
• It typically presents with intermittent, mild unconjugated hyperbilirubinemia, often triggered by physiological stressors like dehydration, fasting, or illness.
• While generally asymptomatic, its presentation during pregnancy is infrequent, posing diagnostic challenges.

Observation:

• A 32-week primigravida presented with vomiting, myalgia, and jaundice.
• Clinical examination revealed icterus and dehydration, with investigations showing mild unconjugated hyperbilirubinemia and hypoglycemia.
• The patient's symptoms and laboratory findings were consistent with Gilbert syndrome, with dehydration exacerbating the jaundice.

Findings:

• Correction of dehydration led to the resolution of jaundice and symptomatic improvement.
• The patient was discharged and later delivered via emergency Cesarean section for fetal distress.
• Both mother and baby had favorable postoperative outcomes.

Implications:

• This case highlights the importance of considering Gilbert syndrome in pregnant patients presenting with jaundice, especially when dehydration is a contributing factor.
• Effective management of dehydration can alleviate jaundice in pregnant individuals with Gilbert syndrome.
• The rarity of Gilbert syndrome in obstetric practice underscores the need for increased awareness and reporting of such cases.