Cholestasis usually occurs during the latter part of a woman’s pregnancy. It is a condition that is characterised by abnormalities in liver function. These abnormalities lead to itching and in the hands, feet and other parts of the expectant mother’s body, often worse at night.
While there maybe no long term complications for the expectant mother this condition can be harmful for the developing baby. Cholestasis of pregnancy is also known as obstetric cholestasis and intrahepatic cholestasis of pregnancy.
Cholestasis of pregnancy is identified by intense itching occurring on the hands, feet and arms. The following symptoms are less common but may also exist for the expectant mother including jaundice, the yellowing of eyes and skin, loss of appetite and nausea. Other than some discomfort there is no long term harm or adverse effect on the the expectant mother. Symptoms will often resolve within a few days of the baby being delivered.
There exact cause for cholestasis in pregnancy is unknown. It is believed that an increase of hormones in an expectant mother’s body increases her fat production which inturn increases the amount of bile in the liver to break down the fat. It’s here in the liver that cholestasis affects the flow of bile out of the liver. This lowered flow causes bile to back up and leak into the bloodstream and depositing in the mother’s skin causing intense itching. The intense itching cannot be cured or relieved by over the counter (OTC) antihistamines but it can be relieved by a prescription medicine, ursodeoxycholic acid.
Increased bile in the expectant mother’s blood stream caused by cholestasis of pregnancy can be harmful to a developing baby. This can include an increased amount of meconium, a substance that accumulates in the baby’s intestines, appearing in the amniotic fluid around the baby. Meconium can cause breathing complications if it is inhaled during the baby’s birth.
Cholestasis of pregnancy can also increase the likelihood of preterm birth and stillbirth in late pregnancy (>38 weeks). The reasons for this are not fully understood and for that reason your doctor may advise you to deliver early, at approximately 37 weeks.
If you believe you have cholestasis of pregnancy please inform your Obstetrician or GP immediately. The only way to diagnosis cholestasis is through a combination of symptoms and blood tests which include elevated liver function tests or bile acids. It is also important to tell your doctor about any family history of any liver problems or cholestasis of pregnancy occurring in previous pregnancies. Then preventative monitoring may begin sooner.
The above information does not take the place of a medical consultation and is intended for informational purposes only. Please consult your doctor if you have any concerns.
This post was written by Dr Anu Kaur