A liver disease that happens in late pregnancy is called cholestasis of pregnancy or intrahepatic cholestasis of pregnancy. It usually causes intense itching on the hands and feet, but it may also happen on other body parts as well. Moreover, itching occurs without a rash.
This condition may make you feel very uncomfortable. However, it significantly increases the risk of developing complications, especially for the baby. For that reason, physicians may recommend preterm delivery (around 37 weeks).
Symptoms
While intense itching is the primary symptom of this disease, it may cause other symptoms as well. Usually, the itching appears on the hands and soles of the feet, but it may happen anywhere on the body. This symptom usually worsens at night and may cause sleeping problems.
Pregnant women usually experience itching in the third trimester of pregnancy, but it goes away completely within several days after delivery. Check below some cholestasis of pregnancy symptoms that occur less frequently:
- Jaundice (yellowing of the skin and eyes)
- Loss of appetite
- Nausea
- Oily and foul-smelling stools
If you experience any of the previous symptoms, immediately contact your healthcare provider.
Causes
While the exact cause of this disease cannot be identified, experts think it happens because of decreased or stopped bile flow. A digestive fluid that helps break down fats is called bile. In people with this disease, the bile begins to build up in the liver instead of leaving it for the small intestine. Increased bile levels in the bloodstream cause the complications and symptoms of this disease. Moreover, the following factors also seem to contribute to cholestasis of pregnancy. For example:
- Hormones – The hormone levels usually increase close to delivery, which may lead to reduced bile flow.
- Genes – In some cases, cholestasis of pregnancy is linked with certain gene mutations (changes) that run in families.
- Environment – While experts do not know the exact environmental factors, the risk fluctuates by geographic location and season.
Risk Factors
Check below some factors that may elevate your risk of developing cholestasis of pregnancy:
- Family history of the disease
- Medical history of liver damage or conditions (including gallbladder stones, hepatitis C, and others)
- Being pregnant with more than one baby
- Becoming pregnant at an older age (more than 35 years old)
If you have a history of cholestasis of pregnancy, the risk of developing it in your next pregnancies increases up to 70%. In such cases, it is called recurrent cholestasis of pregnancy.
What Are The Possible Complications of Cholestasis of Pregnancy?
Usually, cholestasis of pregnancy complications occur due to increased levels of bile in the blood. Moreover, these complications may occur in both mother and baby.
One complication that occurs quite rarely in mothers is a condition that prevents the body from absorbing fat. As a result, it may lead to reduced vitamin K levels, which are important factors involved in blood clotting. Furthermore, people with cholestasis of pregnancy are at increased risk of developing preeclampsia and gestational diabetes.
Complications that occur in babies are usually more severe than in mothers. Check below some examples:
- Premature birth (being born too early)
- Lung problems that cause trouble breathing
- Stillbirth (death of the baby late in pregnancy)
Sometimes, healthcare professionals recommend preterm delivery because complications caused by cholestasis of pregnancy can be too dangerous for the baby.
Unfortunately, there is no sure way to prevent this condition.
Diagnosis
Healthcare providers usually diagnose this condition by performing a physical examination and asking questions about your medical history and symptoms. During the physical examination, they will check you for abnormalities linked with the disease.
To determine how well the liver is working and check levels of bile acids, physicians perform a blood test.
Treatment
The goal of the cholestasis pregnancy treatments is to lessen itching and prevent dangerous complications for the baby.
To reduce itching, doctors usually recommend the following treatments. For example:
- Prescription medicines, including Ursodiol (to reduce bile acid levels in the blood).
- Soak your itchy areas in lukewarm or cool water because it may help lessen itching.
However, before taking any medicines, you should consult with your healthcare professional. Otherwise, it may lead to unpleasant results.
In addition, to reduce the risk of stillbirth, physicians may recommend preterm delivery (near 37 weeks).
Home Remedies
Check below some remedies that may help reduce itching:
- Cool baths
- Oatmeal baths
- Commonly, putting ice on the itchy areas may help lessen the itch
Frequently Asked Questions
What are the symptoms of cholestasis in pregnancy?
The most common symptom of cholestasis in pregnancy is pruritus (also known as severe itching). However, it may cause other symptoms as well. For example:
- Dark urine
- Abdominal (belly) pain
- Nausea
- Appetite changes
- Extreme tiredness
- Insomnia (sleeping disturbances)
- Vomiting
- Stool color changes
If any of the previous symptoms occur, immediately contact your healthcare provider.
What happens if cholestasis goes untreated?
This condition may cause multiple complications for you and your unborn baby. These include:
- Liver disease (including cirrhosis, hepatitis, and others)
- Organ failure
- Sepsis
- Fetal distress
- Meconium in amniotic fluid
- Stillbirth
- Maternal hemorrhage
- Breathing problems
Consult with your healthcare professional about ways to reduce the risk of cholestasis of pregnancy complications.
What are the causes of cholestasis of pregnancy?
Healthcare providers do not know the exact cause of this disease. However, they believe there are multiple factors that contribute to the condition. These include hormonal changes, genetic factors, environmental factors, increased bile production, and others. If you have additional questions, ask your physician.
