Introduction
Cholestasis during pregnancy- Intrahepatic cholestasis of pregnancy (ICP), commonly referred to as cholestasis of pregnancy, is a liver condition that occurs during pregnancy.
ICP temporarily lowers liver function in some pregnant people. This causes bile to build up in your liver and bloodstream. Bile is a substance produced by your liver and stored in your gallbladder. Every time you eat, bile breaks down fats so you can digest them properly. When levels of bile in your blood reach a certain level, you may begin to itch.
Symptoms of Cholestasis in Pregnancy
Cholestasis of pregnancy typically develops in the third trimester (around week 28) when pregnancy hormone levels are at their highest. In some cases, it’s genetic, meaning you’re at higher risk if your biological parents have cholestasis.
Following are the main symptoms of Cholestasis during pregnancy
- Intense Itching: The most common symptom is intense itching, particularly on the palms of the hands and soles of the feet, although it can occur anywhere on the body. The itching often worsens at night.
- Dark Urine: Urine may become darker in color.
- Pale Stools: Stools may become pale or light-colored.
- Fatigue: Women with cholestasis may experience extreme tiredness.
- Jaundice: In some cases, the skin and whites of the eyes may turn yellow (jaundice), although this is less common.
- Decreased appetite.
- Pain in the upper right of your belly.
Risks and Complications for the Mother
- The intense itching can be extremely uncomfortable, leading to sleep disturbances and significant discomfort.
- Cholestasis can interfere with the absorption of fat-soluble vitamins (A, D, E, and K), potentially leading to deficiencies.
- Women with cholestasis may be at an increased risk of developing gallstones due to changes in bile composition.
Risks and Complications for the Baby
- Cholestasis is associated with an increased risk of preterm labor and delivery. Preterm babies may face challenges related to underdeveloped organs.
- Elevated bile acids can affect the baby, leading to fetal distress. This may include abnormal heart rates and decreased oxygen levels.
- There is a higher risk of the baby passing meconium (the first stool) in the womb, which can lead to complications if inhaled during birth (meconium aspiration syndrome).
- Cholestasis of pregnancy carries a higher risk of stillbirth, especially if not closely monitored and managed.
Diagnosis and Monitoring
Cholestasis of pregnancy diagnosis by a physical examination and blood test. These tests tell how your liver functions and measure the level of bile acids in your bloodstream using a serum bile acid test.
Treatments
Treatments to manage the symptoms of cholestasis of pregnancy.
- Healthcare providers use medication that can improve your liver’s ability to function and reduce bile levels in your blood.
- Anti-itching creams may be used to manage itching.
- If vitamin deficiencies are suspected, supplements, particularly of vitamin K, may be recommended to reduce the risk of bleeding complications during delivery.
- To reduce the risk of stillbirth, healthcare providers may recommend inducing labor between 36 and 37 weeks of pregnancy, depending on the severity of the condition and the baby’s development.
Cholestasis symptoms typically resolve after delivery as bile acid levels return to normal.
FAQ
What week does cholestasis of pregnancy start?
Cholestasis of pregnancy is more likely to begin after the 28th week of pregnancy but it can start earlier.
Can you have a healthy baby with cholestasis of pregnancy?
Yes, just because you have cholestasis during pregnancy doesn’t mean your baby will be unhealthy.
What complications are associated with cholestasis of pregnancy?
Cholestasis of pregnancy may cause complications. You may have problems absorbing vitamin K
Fetal complications related to cholestasis of pregnancy-
•Premature birth.
•Stillbirth.
•Fetal distress. Meconium aspiration.
What foods should I avoid?
It would be best to eat a balanced diet emphasizing fruits, vegetables, lean meat or other protein sources during pregnancy.
Also read, Thyroid affects conceiving and pregnancy?