WHAT IS OB­STET­RIC CHOLESTASIS?

Your Pregnancy - - Q&A Mongth 6 -

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.

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