What is cholestasis of pregnancy?

Cholestasis of pregnancy is a condition occurring in the late months of a pregnancy. It often triggers intense itching, usually on the hands and feet, but the itching may affect many other parts of the body. Although this condition is unpleasant, it poses no long-term risk to an expectant mother. In terms of the developing baby, cholestasis of pregnancy, however, can be dangerous. Health care providers usually recommend early delivery. The term “cholestasis” refers to any condition that slows or stops the flow of bile, digestive fluid from the liver. Pregnancy is considered to be one of many possible causes of cholestasis.

Signs and symptoms of cholestasis of pregnancy

Intense itching is an early sign of cholestasis of pregnancy. Most pregnant women with cholestasis tend to feel itchy on the palms of their hands or the soles of their feet. Some women, however, feel itchy everywhere. At night, the itching usually gets worse and may be so uncomfortable that you are not able to sleep. It is believed that the itching most commonly happens during the third trimester of pregnancy. But, sometimes, it may begin earlier. Once your baby arrives, the discomfort usually goes away within a few days.

Some of other less common signs and symptoms of cholestasis of pregnancy may include the yellowing of the skin and whites of the eyes (jaundice), nausea, loss of appetite, etc.

Who is more likely to get cholestasis of pregnancy?

Major risk factors of cholestasis of pregnancy include:

– A personal or family history of cholestasis of pregnancy

– A history of liver disease

– A twin pregnancy

While some of these risk factors are genetic, most of them have something to do with the increased levels of pregnancy hormones. After you have had the condition, the risk of developing it during a subsequent pregnancy is probably higher. About half to two-thirds of women experience the recurrence of cholestasis of pregnancy.

What causes cholestasis of pregnancy

The exact cause of this condition remains unexplained. Many researchers believe that there may be a genetic component as the condition sometimes runs in families and certain genetic variants have been associated with it.

Pregnancy hormones may also play a role in causing cholestasis of pregnancy. Bile is a digestive fluid produced in the liver. It helps the digestive system break down fats. It is possible that the increase in pregnancy hormones in the third trimester may slow the normal flow of bile out of the liver. Eventually, the bile buildup in the liver allows bile acids to enter the blood stream. Itching is the consequence of deposited bile acids in the mother’s tissues.

Diagnosis and treatment for cholestasis of pregnancy

In order to detect cholestasis of pregnancy, your health care provider may ask you some questions about your signs, symptoms, and medical history. He or she will also perform a physical examination. Your health care provider may recommend you to do some tests, such as blood tests. Then, they will send blood samples for lab testing to evaluate how well your liver is working and measure the level of bile salts in your blood.

To relieve intense itching, you need to take ursodiol, a prescription medication that helps decrease the level of bile in your bloodstream, relieves itchiness and may reduce complications for the baby.

Unfortunately, itching due to cholestasis of pregnancy does not respond well to home remedies. Warm baths seem to soothe the intensity of the itching for some women. Soaking affected areas in lukewarm water may help, too. You can also try icing a particularly itchy patch of skin, but it only works temporarily.


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Hello Health Group does not provide medical advice, diagnosis or treatment.

Assoc. Prof. Dr. Thuaibah Bt Hashim Pathology - Histopathology & Cytology
Assoc. Prof. Dr. Thuaibah Bt Hashim is currently a lecturer in Pathology at Cyberjaya University College of Medical Sciences, Malaysia, under the Department of Basic Medical Sciences, Faculty of Medicine. Dr. Thuaibah is a pathologist expert, subspecialized in Renal Histopathology. Besides teaching, her extracurricular activities involve various charity events under Pertubuhan Ikram Putrajaya and Surau AlMunawwarah Bangi Golf Resorts.She is also a member of Persatuan Perubatan Islam Malaysia; College of Pathologists, Academy of Medicine Malaysia; and the Persatuan Alumni Sekolah Seri Puteri. Dr. Thuaibah has various publications about Pathology and prestigious awards, including: 1. Certificate of appreciation and incentive for contributing to eradicate an outbreak of Nipah encephalitis in Negeri Sembilan from Ministry of Health Malaysia, 1999. 2. Prize & Certificate of Excellent Service in conjunction with the Quality Day, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia 2002. 3. Outstanding Service Award 2003 from Universiti Putra Malaysia. 4. Anugerah Jasa Putra 2006 from Universiti Putra Malaysia.
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