Pregnancy is an exciting and joyful journey, but it can also come with its share of challenges. One such condition that some pregnant women might encounter is cholestasis of pregnancy. Though it sounds complicated, understanding it is essential for ensuring both the mother’s and baby’s well-being. In this blog, we’ll break down the cholestasis of pregnancy, its symptoms, causes, risks, and treatment options in simple, easy-to-understand language.
What is Cholestasis of Pregnancy?
Cholestasis of pregnancy, also known as intrahepatic cholestasis of pregnancy (ICP), is a liver disorder that occurs during pregnancy. The liver produces bile, a fluid that helps in digesting fats. In cholestasis, bile from the liver slows down or gets blocked, causing bile acids to build up in the liver and spill into the bloodstream. This condition usually occurs in the third trimester and can cause significant discomfort for the mother and potential risks for the baby.
What Causes Cholestasis of Pregnancy?
The exact cause of cholestasis in pregnancy isn’t entirely understood, but it is believed to be related to hormonal changes during pregnancy. As pregnancy progresses, hormone levels, especially estrogen, increase significantly. This hormone surge can affect the liver’s ability to handle bile effectively, leading to cholestasis.
Genetics may also play a role. If your mother or sisters had cholestasis during their pregnancies, you may be more likely to develop the condition. Additionally, cholestasis is more common in women carrying multiples, such as twins or triplets.
Recognizing the Symptoms
The most common and noticeable symptom of cholestasis of pregnancy is intense itching, particularly on the hands and feet. This itching can be more severe at night and might spread to other parts of the body. Unlike typical itching during pregnancy, which can be due to dry skin or stretching, the itching in cholestasis is often more intense and persistent.
Other symptoms may include:
- Dark urine: Your urine may appear darker than usual.
- Pale stools: Stools might be lighter in color.
- Fatigue: Feeling more tired than usual is common.
- Jaundice: A yellowing of the skin and eyes, though this is less common.
It’s important to note that some women may not experience all these symptoms, so if you notice persistent itching, especially in the third trimester, it’s important to talk to your doctor.
Why is cholestasis of pregnancy a concern?
While cholestasis of pregnancy can be uncomfortable for the mother, the primary concern is its potential impact on the baby. Bile acids, when not properly cleared from the liver, can cross the placenta and affect the baby. Risks include:
- Preterm birth: Babies might be born before their due date, which can lead to complications related to premature birth.
- Fetal distress: The baby may not be getting enough oxygen, leading to distress.
- Meconium staining: The baby might pass its first stool (meconium) before birth, which can cause breathing problems if inhaled into the lungs during delivery.
- Stillbirth: In rare cases, cholestasis of pregnancy can lead to stillbirth, which is why early diagnosis and management are crucial.
Diagnosing Cholestasis of Pregnancy
If you experience intense itching during pregnancy, your doctor will likely perform a few tests to determine if you have cholestasis. These may include:
- Blood tests: To measure liver function and bile acid levels in the blood.
- Liver function tests: To assess how well your liver is working.
Your healthcare provider may also monitor your baby more closely with additional ultrasounds and non-stress tests to ensure they are healthy and not in distress.
Managing and Treating Cholestasis of Pregnancy
Once diagnosed, managing cholestasis of pregnancy involves reducing symptoms and minimizing risks to the baby. Treatment options may include:
- Medication: Ursodeoxycholic acid (UDCA) is commonly prescribed to help reduce bile acid levels and alleviate itching. It’s considered safe for both mother and baby.
- Early delivery: Since the risks to the baby increase as pregnancy progresses, doctors may recommend inducing labor around 37 to 38 weeks. This reduces the risk of stillbirth and other complications.
- Regular monitoring: Your doctor will likely want to monitor your liver function and bile acid levels regularly. Frequent ultrasounds and fetal monitoring may also be recommended to check on the baby’s well-being.
In addition to medical treatments, some home remedies may help manage symptoms:
- Moisturize your skin: Use gentle, fragrance-free lotions to soothe itching.
- Cool baths: Taking a cool bath can provide temporary relief from itching.
- Wear loose, comfortable clothing: Tight clothing can make itching worse, so opt for soft, breathable fabrics.
What Happens After Delivery?
The good news is that cholestasis of pregnancy usually resolves after the baby is born. Once the baby is delivered, your hormone levels will begin to return to normal, and the liver should start functioning properly again. Most women find that their symptoms, including itching, disappear within a few days to weeks after childbirth.
However, it’s important to follow up with your doctor after delivery to ensure your liver function has returned to normal. Also, having cholestasis in one pregnancy increases the likelihood of developing it in future pregnancies, so it’s something to be mindful of if you plan to have more children.
Can Cholestasis of Pregnancy Be Prevented?
Unfortunately, there’s no surefire way to prevent cholestasis of pregnancy, especially if you have a family history or are carrying multiples. However, being aware of the symptoms and getting regular prenatal care can help ensure early detection and management, reducing risks to both you and your baby.
Conclusion
Cholestasis of pregnancy can be a problematic condition, but with proper medical care and monitoring, the risks to both mother and baby can be managed effectively. If you’re pregnant and experience unusual symptoms like intense itching, especially in the third trimester, don’t hesitate to contact your healthcare provider. Early diagnosis and treatment are key to ensuring a healthy pregnancy and delivery.
Remember, while cholestasis of pregnancy is serious, many women with the condition go on to have healthy babies with the right care. Stay informed, trust your instincts, and work closely with your healthcare team to confidently navigate your pregnancy. If you are looking for a Gynecologist in Hinjewadi then you can consult Dr. Prajakta Sabale. She is one of the Best Gynecologists and cholestasis experts for any guidance or suggestions you can visit her clinic in Hinjewadi.