What is cholestasis of pregnancy?

Cholestasis of pregnancy, also known as intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis, is a liver condition that leads to severe itching during the later stages of pregnancy.

In a few pregnant persons, ICP temporarily lowers your liver function. The bile builds up in your liver and bloodstream due to this fact. Bile is a digestive fluid produced in the liver and is stored in your gallbladder. Every time you eat, bile breaks up fats so they can be appropriately broken down in your system. When a build-up of such bile is in the blood, itching may start at a certain point.

You and the fetus will be at risk for complications with cholestasis of pregnancy. To reduce your chances of complications, your pregnancy care provider may closely follow you throughout your pregnancy.

How prevalent is cholestasis in pregnancy?

Cholestasis occurs in approximately 1 to 2 per 1,000 people who are pregnant. ICP is more commonly diagnosed in people during the winter months, but researchers are not sure why. Data also indicates that it is more common in people with Hispanic and Swedish backgrounds.

What are the symptoms of cholestasis in pregnancy?

The primary symptom of cholestasis of pregnancy is severe itching or pruritus. Itching begins on the hands and feet and spreads throughout the body, typically worsening at night. Unlike most other conditions with itching, cholestasis of pregnancy does not cause a rash.

Some less common signs of cholestasis may be:

• Nausea.
• Dark urine.
• Light grey or pale brown stool.
• Extreme fatigue.
• Loss of appetite.

You have pain in the upper right side of your abdomen. You might also observe yellowing of your skin and the whites of your eyes, a condition known as jaundice.

What is the main cause of cholestasis in pregnancy?

Bile is a liquid made by your liver. It is stored in your gallbladder. Your liver assists in digestion by breaking down fats. High estrogen and progesterone levels during pregnancy impact your liver's functions that carry bile. This would mean your bile is not moving throughout your body and builds inside your liver and bloodstream. This can make you feel itchy from the bile entering your blood.

Cholestasis of pregnancy usually starts in the third trimester, around week 28, when hormone levels are highest. In some cases, it runs in families, so you may be at greater risk if your parents had cholestasis.

How early does cholestasis of pregnancy begin?

Cholestasis of pregnancy is more likely to start after the 28th week but may start earlier.

What is the diagnosis for cholestasis of pregnancy?

Your pregnancy care provider diagnoses cholestasis of pregnancy through a physical exam and blood tests. These tests assess liver function and measure bile acid levels in your blood using a serum bile acid test.

Tests accurately confirm the diagnosis when the total bile acids exceed 10 micromoles per liter. A micromole is a unit of measurement used in certain medical tests. You may have blood tests periodically throughout your pregnancy to assess the level of bile in the blood.

Your provider may want a prothrombin time test to assess how well your blood will clot or an ultrasound to examine your bile ducts and liver.

How to treat cholestasis of pregnancy?

Healthcare providers use ursodeoxycholic acid (UDCA, ursodiol, or Actigall®) to treat cholestasis of pregnancy. This medicine can improve liver function and reduce bile levels in the blood.

To manage the symptoms of cholestasis of pregnancy, you can:

• Talk to your provider about taking anti-itch medicine.
• Wear soft, loose-fitting clothes.
• Get plenty of rest.
• Soak in a warm bath.

If medication does not reduce your bile levels, your healthcare provider may suggest delivering your baby early. The risk of complications from cholestasis of pregnancy might be decreased by inducing labor between weeks 37 and 38 of pregnancy. Your healthcare provider will watch for signs of any potential problems in the fetus with tests like a biophysical profile or nonstress test.

If your healthcare provider delivers your baby early, they will probably give your baby a steroid to help their lungs develop. They will also provide a vitamin K supplement to prevent internal bleeding.

What are the risk and complications in cholestasis of pregnancy?

Cholestasis of pregnancy can lead to serious problems. It may make it hard for you to absorb vitamin K, which raises the risk of heavy bleeding. This condition is also linked to preeclampsia and gestational diabetes.

Possible fetal problems from cholestasis of pregnancy include:

• Premature birth
• Stillbirth
• Fetal distress
• Meconium aspiration

To avoid these issues, your pregnancy care provider might decide to deliver your baby early.

Do I have the chance to carry a healthy baby with cholestasis of pregnancy?

Yes, cholestasis during pregnancy doesn't necessarily mean your baby will be unhealthy.

What should I avoid eating when I have cholestasis in pregnancy?

Your pregnancy care provider may advise you to avoid certain foods depending on your condition. However, there is no specific diet to adhere to when suffering from cholestasis during pregnancy. Eat a balanced diet. Include plenty of fruits, vegetables, lean meats, or other protein sources.

Can cholestasis of pregnancy be prevented?

You cannot stop cholestasis of pregnancy. Genetic testing can help you determine if you might pass this condition to your child.

What are the risk factors for cholestasis during pregnancy?

You are at a higher risk for developing cholestasis of pregnancy if you:

• Have a family member with the condition.
• Had ICP before.
• Are you pregnant with twins, triplets, or more?
• Do you have a history of liver disease or hepatitis C?
• Have you ever experienced liver damage?
• You have a genetic disorder that impacts your body's process of producing and using bile.

What is the prognosis (outcome) for someone who has cholestasis during pregnancy?

Cholestasis during pregnancy resolves in a few days after delivery. Your bilirubin returns to normal at the time of delivery. Medication can then be discontinued, and you can maintain normal levels again.

Most people with this condition do not have liver problems again unless they become pregnant once more. There is approximately a 60% chance of experiencing cholestasis in future pregnancies. If you had a severe case of cholestasis, your likelihood of having it again in future pregnancies increases to as high as 90%.

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When should I call my healthcare provider?

If you experience severe itchiness that persists during pregnancy, or if your skin or the whites of your eyes appears yellow. Immediately contact your pregnancy care provider.

Why choose Tender Palm Super-Speciality Hospital for Cholestasis of pregnancy treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced treatment for Cholestasis in pregnancy in Lucknow, India, at an affordable cost. We have a team of experienced gynecologists, obstetricians, and maternal–fetal medicine specialists, known as some of the best doctors for high-risk pregnancy care. We provide accurate diagnosis through blood tests and liver function assessment, personalized medical treatment, and close monitoring to ensure the safety of both mother and baby. Our gynecology and maternity team has decades of experience in successfully treating Cholestasis in pregnancy cases in Lucknow, India.

To seek an Expert Consultation for Cholestasis of pregnancy treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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