Cholestasis of Pregnancy

If you experience intense itching during pregnancy, you might be suffering from cholestasis. This goes beyond the normal itching you might experience as your belly stretches to accommodate your growing baby. Cholestasis of pregnancy often happens when a condition impairs the flow of bile from the liver. It often happens in late pregnancy, and might be known as intrahepatic or obstetric cholestasis.

What Are the Symptoms and Signs of Cholestasis of Pregnancy?

Itching is normal in many conditions. This is especially true during the last few months of pregnancy, when your belly expands dramatically to accommodate the new life inside. But cholestasis of pregnancy can be very different. You might experience the following symptoms:

  • Itching that is everywhere over your body, especially on your hands and feet
  • Itching that gets worse as the evening goes on
  • Antihistamines, such as Benadryl, don't work at all to relieve the itching
  • If you have a blood test done, your doctor will find elevated serum bile acid and liver function test results

You might also experience some of the less common signs, such as fatigue, a decrease in appetite, nausea, darker urine, lighter stools, jaundice, pain in the upper right of your abdomen, and increased time necessary for your blood to clot.

What Causes Cholestasis of Pregnancy?

No one knows for sure what causes cholestasis of pregnancy, but for some women,it might be connected with the following causes.

Pregnancy hormones can have an effect on all areas of your body, including your liver. When bile doesn't flow properly, you are at risk for developing cholestasis. You might also be at higher risk if you are carrying multiples, have had previous liver damage, or have had IVF treatments.

Some women are prone to the itching because they have a family history of it. This genetic predisposition means that you might have a hereditary problem that leads to issues with bile flow. However, some women who have a family history of cholestasis during pregnancy never actually develop the problem themselves.

Finally, some researchers have found evidence that the environment plays a factor. Those who are pregnant during the winter months are more likely to develop the problem. It might also be a reduced exposure to sunlight or a change in diet. Researchers are always trying to learn more about what might trigger the condition.

Will Cholestasis of Pregnancy Influence Your Baby?

Unfortunately, your baby can be affected by cholestasis. The problem might lead to preterm birth, or the baby might release meconium into the amniotic fluid before delivery. This can then lead to aspiration of the meconium, which can cause breathing problems. Finally, severe cholestasis can mean an increased risk of fetal death in late pregnancy. Obviously these reasons are more than enough to see your doctor when you start to feel that terrible itching.

How to Prevent the Effects on Baby

The good news is that you can prevent some of the complications your baby might suffer due to this problem. Getting regular non-stress tests, as well as biophysical profile scores, can help ensure your baby on the right and healthy track. You might also make the decision to deliver your baby early, usually around 37 weeks, in order to cut down on the risk of fetal death later in the pregnancy. 

Can Cholestasis of Pregnancy Be Cured?

Unfortunately, there is no cure for cholestasis of pregnancy. However, there are treatments that might help take the edge off the itching. Without any treatments at all, the itching usually stops shortly after delivery, when hormone levels begin to return to normal. In the meantime, try these tips:

  • Get a lukewarm shower or bath when you begin to suffer from the itching
  • Ask your doctor for a prescription medication like as Actigall or Urso. These medications are safe to take during pregnancy. They reduce the level of bile in your blood, which can help reduce the problem.
  • Avoid corticosteroid creams or lotions, as they don't work on the itching either.
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