Cholestasis of pregnancy causes severe itching and sometimes jaundice. Most frequently occurring in late pregnancy, cholestasis affects 1 or 2 women out of 1000. Women carrying multiples, who have a family history of cholestasis, getting pregnant through the use of in-vitro fertilization (IVF) or who have suffered previous damage to their liver are most at risk. While the itching can be so severe it disrupts a woman’s life, most of the issues with this condition revolves around the baby. This condition is also known as obstetric cholestasis and intrahepatic cholestasis of pregnancy.
What Causes Cholestasis?
Cholestasis is a liver disease. It only occurs in pregnancy, and while the cause is unknown, it is thought that the flow of bile from the gallbladder may be affected by the hormones of pregnancy. It is most common for women to suffer from this condition during the last trimester when these hormones are at their highest levels. Bile is required to help break down fats during digestion, and when it is slowed or stopped, the collected acids in the liver may overflow into the bloodstream.
Problems Caused by Cholestasis
Women affected with cholestasis of pregnancy may suffer from itching that ranges from annoying to severe. Itching may increase at night. The itching may be all over the body or focus on the palms of the hands and the soles of the feet. Exhaustion, loss of appetite, nausea and depression may also occur. Any time itching may cause a scrape or cut in the skin, infection may occur. She may also have problems absorbing fat-soluble vitamins like A, D, E and K. The biggest risk for the mother is the recurrence of the condition in a future pregnancy. Hemorrhage is a concern for both mother and baby.
Cholestasis of pregnancy can affect the baby by increasing the risks of stillbirth, preterm birth or fetal distress. The baby’s liver may get stressed since the mother’s liver is not removing bile acids efficiently. Due to the stress on the baby’s system, they may release meconium (their first bowel movement) before they are born and inhale it. This may cause breathing problems.
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