Cholestasis of pregnancy: symptoms and treatment

Cholestasis of pregnancy: symptoms and treatment


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THE cholestasis of pregnancy or intrahepatic cholestasis of pregnancy is a rare condition that affects the liver and causes itching, sometimes very severe, in pregnant women.

  • What is cholestasis of pregnancy

  • Causes of cholestasis of pregnancy

  • Risk factors of cholestasis of pregnancy

  • Main symptom of cholestasis of pregnancy

  • Consequences of cholestasis for the mother

  • Cholestasis in pregnancy harms the baby

  • Treatment for cholestasis

  • Woman with cholestasis may become pregnant again

What is cholestasis of pregnancy

Under normal conditions, bile flows through the bile ducts until it reaches the intestine. However, when there is a problem of cholestasis, the bile flow to the intestine is reduced, causing acids or bile salts to start accumulating in the body. The increased concentration of these substances creates problems especially on the pregnant woman’s liver.

Causes of cholestasis of pregnancy

The exact causes of cholestasis in pregnancy are still unknown. Recent studies, however, have raised the hypothesis that there is a family predisposition to suffer from this problem. More in-depth analyzes are needed to clearly determine what causes this condition among pregnant women.

Risk factors of cholestasis of pregnancy

Some experts believe that the estrogen and progesterone, sex hormones that have an increased production during pregnancy, are the cause of cholestasis. Women with this condition would have a particularly high sensitivity to high levels of these hormones and this can affect their liver function.

Main symptom of cholestasis of pregnancy

The main symptom is itch. This situation, however, is common during pregnancy and can have common causes. When it comes to cholestasis, itching is usually concentrated in thepalms and soles. The itching, in general, is very intense and worsens at night. Although there is no rash, some women can scratch their skin until they bleed.

In some of them there are also jaundice, darkened urine and lighter colored stools. There may also be something blocking the flow of bile to the intestine. An ultrasound can check for gallstones. Women with cholestasis are more likely to develop these stones.

Consequences of cholestasis for the mother

Probably having intrahepatic cholestasis does not cause damage to health of the mother in addition to the itching, which can be very unpleasant and continue until after delivery. Sometimes, cholestasis can affect the blood coagulation and sometimes vitamin K supplementation may be necessary during pregnancy.

Cholestasis in pregnancy harms the baby

One of the most important consequences is the increased risk of premature birth. One in 10 women who suffer from this problem have their baby before the 37th week of pregnancy. Obstetricians recommend inducing labor at 37 weeks, as there is an increased risk of sudden fetal death from this stage of pregnancy. In addition, the baby is more likely to produce meconium (first stool) still in the womb, which causes breathing problems if swallowed.

Treatment for cholestasis

The only cure for cholestasis of pregnancy is delivery. To treat itching you can use a cream or antihistamines. Widely used in cases of cholestasis, the ursodeoxycholic acid has no scientific guarantee of being safe for the baby. From six to eight weeks after delivery, a doctor’s appointment should be made to ensure that the itching is gone and the liver is functioning properly.

Woman with cholestasis may become pregnant again

It may be necessary in the future for women to avoid certain types of birth control pills. In addition, the likelihood that she will again suffer from intrahepatic cholestasis in a subsequent pregnancy is high.

Photo: © Tatyana Vyc – Shutterstock.com

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