Cholestasis of pregnancy causes itching
Janine Gard is a diploma-qualified birth educator (2005) and founder of Bellies to Babies antenatal and postnatal classes. She has helped more than 3700 parents prepare themselves mentally, emotionally and physically for their journey to parenthood, and l
Cholestasis of pregnancy is a liver condition that causes severe itching late in pregnancy. It’s alsoknownas intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis.
ICP temporarily lowers liver function in somepregnant people. This causes bile to buildup in your liver and bloodstream. Bile is a substance produced by your liver and stored in your gallbladder. Every time you eat, bile breaksdownfats so you can digest themproperly. Whenlevels of bile in your blood reach a certain level, youmaybegin to itch.
Cholestasis of pregnancy can cause complications for you and your baby. Tolower the risk of complications, your lead maternity carer (LMC) maymonitor you and your baby closely for the remainder of your pregnancy.
Whathappens if Ihave cholestasis while pregnant?
During pregnancy, your baby relies onyour liver to remove waste from its blood. Your liver is an important organ responsible for removing waste from your body, so whenit’s not fully functioning, it can cause complications. If your liver isn’t functioning properly, bile levelsmay increase to unsafe levels thatmay stress your baby’s liver.
Howcommonis cholestasis duringpregnancy?
Cholestasis affects about one to two inevery 1000people during pregnancy.
Whatis themaincauseof cholestasis duringpregnancy?
Bile is a substancemadeby your liver and stored inyour gall bladder. Your liver helps breakdownfats duringdigestion. Increased levels of oestrogen and progesterone during pregnancy affect your liver’s ability to transport bile. Thismeansyour bile doesn’tmovethrough your body properly, causing it to buildup in your liver and enter your bloodstream— and this canmakeyoufeel extremely itchy.
Cholestasis of pregnancy typically develops in the third trimester (aroundweek 28 gestation) when pregnancyhormone levels are at theirhighest. In somecases, it’s genetic, meaning you’re at higher risk if your biological parents have cholestasis.
Whatare thesymptomsof cholestasis?
The main symptomof cholestasis is severe itching (pruritus). This itching starts on your hands and feet and spreads to other body parts. It is usually worse at night. Unlike other conditions that cause itching, cholestasis doesn’t involve a rash.
Less commonsigns of cholestasis mayinclude:
Nausea
Dark urine
Light gray or pale brownpoop Extreme tiredness Decreased appetite
Pain inthe upper right of your belly Jaundice (yellowing of your skin and whites of your eyes)
Howis it diagnosed?
YourLMCwill do a physical examination and blood tests. These tests tell your providerhowyour liver is functioning. They’ll also measure the level of bile acids inyour bloodstream using a serum bile acid test.
Tests confirm thediagnosiswhen total bile acids are 10 micromoles per litre or above. Amicromole is a unit of measurement used insome medical tests. Youmayhave blood tests regularly for the remainder of your pregnancy to monitor bile levels in your blood.
Your providermayalso order a prothrombin time test to seehowwell your blood clots or anultrasound to look at your bile ducts andliver.
Howis itmanagedor treated?
medication to improveyour liver’s ability to function and reduce bile levels inyour blood
anti-itch creams or lotions— check with yourLMCbefore using any products
wearing soft and loose-fitting clothing rest sitting directly in front of a fan, soaking in a cool bath, andapplying ice packs for short periods to affected areas
applying naturally-cooling substances, such as aloe to affected areas before rinsing off in a shower
wearing cool, loose, cotton clothing using unperfumed lotion or soap
Are thereanycomplications? Cholestasis of pregnancymay cause complications for you and your unborn baby. Youmayhave problems absorbing vitaminK, which increases the risk of haemorrhage (heavy internal bleeding). It’s also associated with pre-eclampsia and gestationaldiabetes.
Complications for your unborn baby related to cholestasis of pregnancy include: Premature birth
Stillbirth
Fetal distress Meconiumaspiration YourLMCmaysuggest an induction to deliver your baby early to decrease the risk of these complications.
Pregnancy can be an emotional experience but if you are diagnosed with a complication such as ICP, this maycausesome stress and anxiety. Tell your midwife orGPif you are finding it hard to cope with these feelings.
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Medical disclaimer: This page is for educational and informational purposes only and may not be construed asmedical advice. The information is not intended to replace medical advice offered by physicians.