WHAT IS OBSTETRIC CHOLESTASIS?

Q:I heard about a cousin’s friend who suffered from obstetric cholestasis during all of her pregnancies and all three her children had to be induced a month early to prevent them being stillborn. What is this condition and how common is it? Is there something I can do to avoid it?

A:Tina answers: Obstetric cholestasis (OC) is a liver disease that occurs only in pregnancy. What happens is that the fine ducts secreting bile in the liver become obstructed, so bile can’t be excreted and is reabsorbed into the blood. This leads to an excessive accumulation of bile salts in the blood, which manifests as itchy skin. The exact cause is unknown but there appears to be susceptibility in certain families. OC only occurs in the last 10 weeks of pregnancy. Usually the only symptom is itching, particularly on the arms, legs, hands and feet. The itching is often worse at night, leading to sleeplessness and exhaustion. After two to four weeks, mild jaundice may develop, which shows as a yellow colour in the whites of the eyes. OC is uncomfortable for the mother but not life threatening. It can however have serious consequences for the baby, unless recognised in time. This condition may cause labour to begin prematurely (before 37 weeks) or if the pregnancy reaches 37 weeks, it may be necessary to induce the labour. OC can be detected by a blood test that measures liver enzymes and bile acid level. Itching in pregnancy is common, however should you develop a rash and itching together please discuss this with your caregiver.