:quality(85)//cloudfront-us-east-1.images.arcpublishing.com/infobae/NXZB6JKMIRH4HFMLC737T65QBE.jpg "Cholestasis of pregnancy: what are its symptoms, causes and treatment 1")
Intrahepatic cholestasis of pregnancy, commonly known as “cholestasis of pregnancy”, is a liver disorder that occurs late in pregnancy. The disease causes intense itching without a rash. Itching usually appears on the hands and feet, but it can also affect other parts of the body.
Pregnancy cholestasis can make you feel extremely upset. However, most worrying are the possible complications for you and your baby. Due to the risk of complications, your doctor may recommend that you give birth earlier.
Symptoms
Intense itching is the main symptom of cholestasis of pregnancy. There are no rashes. Most women experience itching on the palms of their hands or the soles of their feet, although many others experience itching all over their body. Itching is usually worse at night and can be so annoying that it won’t let you sleep.
Itching is more common during the third trimester of pregnancy, but sometimes it starts earlier. This can get worse as the due date approaches. However, once the baby arrives, the itching usually subsides within a few days.
Other less common signs and symptoms of cholestasis of pregnancy include: Yellowing of the skin and whites of the eyes (jaundice) Nausea Loss of appetite
When to see the doctor
Some of the factors that can increase the risk of cholestasis of pregnancy include: Personal or family history of cholestasis of pregnancy History of liver damage or disease Twin pregnancy or multiple pregnancy
About 60% to 70% of women have a recurrence. In severe cases, the risk of recurrence can reach 90%.
Diagnostic
The goal of treatment for cholestasis of pregnancy is to relieve itching and prevent complications for your baby.
relieves itching
To soothe intense itching, your pregnancy care provider may recommend: Take a prescription medicine called ursodiol (Actigall, Urso, Urso Forte) which helps reduce the level of bile in your blood. Other itch medications may also be an option. Soak the affected areas in cold or lukewarm water.
It’s a good idea to talk to your pregnancy care provider before you start taking medication to treat itching.
Checking your baby’s health
Cholestasis of pregnancy can lead to pregnancy complications. The professional in charge of your pregnancy care may recommend careful monitoring of the baby during pregnancy.
Monitoring and treatment may include: Test at rest. During a non-stress test, your pregnancy care provider will check your baby’s heart rate and how it increases with movement. Fetal biophysical profile. This series of tests helps to monitor the well-being of the baby. It provides information about the baby’s movements, muscle tone, breathing, and amount of amniotic fluid. Although the results of the non-stress test and the fetal biophysical profile may be encouraging, they do not really predict the risk of preterm birth or other complications associated with cholestasis of pregnancy. Early induction of labor. Even if prenatal tests appear normal, your pregnancy care provider may suggest an early induction of labor due to the risk of stillbirth.
Early delivery
Even if prenatal tests are within standard limits, your pregnancy care provider may suggest inducing labor earlier than expected. Early delivery, around 37 weeks, can reduce the risk of stillbirth. Vaginal delivery is recommended by induction of labor unless there are other reasons why a caesarean section is needed.
The future birth control
A history of cholestasis during pregnancy may increase the risk of symptom recurrence with estrogen-containing contraceptives, so other methods of birth control are usually recommended. These include contraceptives containing progestin, intrauterine devices (IUDs), or barrier methods, such as condoms or diaphragms.