Cholestasis of Pregnancy: Signs, Symptoms, Causes, Risk to the Baby, Treatment


Cholestasis of pregnancy is also called Intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis. This is a condition that develops in some pregnant women in the later stage, usually during the third trimester. It is characterised by severe itching due to a liver disorder during this period of pregnancy. Intrahepatic cholestasis of pregnancy (ICP) is mainly caused due to the amount of bile secretion from the liver being affected by an increased flow of pregnancy hormones. In the third trimester, the pregnancy hormones are at their raging peak, and hence this situation arises during that time and usually subsides within a few days after delivery. Cholestasis of pregnancy is not a very common disorder, and is not worrisome if diagnosed and treated within a proper time frame. The Cincinnati Children’s Hospital says that ICP affects about 1 in every 1000 women in the US. What is important is to know the symptoms for timely diagnosis. The major signs of cholestasis of pregnancy are:

Cholestasis of Pregnancy: Signs, Symptoms, Causes, Risk to the Baby, Treatment

  • Extremely itchy hands and feet – mainly in the palms and soles
  • Yellowing of the skin
  • Acute pain in the right upper quadrant (RUQ)
  • Dark coloured – brownish – urine
  • Light coloured stool
  • Discomfort in digestive tract and its surrounding areas
  • Loss of appetite
  • Increased nausea
  • Fatigue
  • Anxiety and depression

Cholestasis of Pregnnacy

You must be aware of the risk factors of cholestasis of pregnancy, in order to be able to keep a tab on your regular visit to the gynaecologist’s chamber. By now you know that the major known cause of cholestasis is the distortion of the bile excreted by your liver. In this condition, the bile is accumulated in the blood stream due to its passage being blocked by thick hormones flowing throughout your body, especially in the area surrounding your reproductive system. Your situation can be diagnosed as a condition of cholestasis if your total bile acids (TBA) or serum bile acids are counted at 10 micromol/L and more. You are at a greater risk of developing Intrahepatic cholestasis of pregnancy (ICP), if you have possess any of these characteristics or have experienced of these factors:

  • You are carrying more than one foetus
  • You have had major liver problems earlier in life
  • You mother or elder sister was diagnosed with Intrahepatic cholestasis of pregnancy at some point

Cholestasis can be harmful towards your baby, if not diagnosed in proper time. The risk to the baby involves damage to their liver due to the extra strain on its liver too. Apart from that, the excess hormones that cause the flow of bile to get blocked, might also negatively affect the baby’s neurological development. The most common and major risks to the foetus involve:

  • Being born prematurely, pre-term, and hence not being able to survive under normal conditions, without life support.
  • Still born baby, which usually passes a few hours before delivery, while the mother goes into labour.
  • Being born with lung problems and breathing issues like asthma due to a green sticky substance called meconium being collected in the foetus’ intestines and the amniotic fluid.

The best way to avoid the baby from bearing the risk factors of your cholestasis of pregnancy is to get yourself diagnosed well. Consult the doctor immediately after you encounter the plausible symptoms of this disease. The diagnosis consists of two simple processes:

  • Blood tests to detect the liver’s functioning and secretion of bile and bilirubin.
  • Complete medical examination – taking into account the patient’s history of miscarriage and cholestasis in the family.

This disease is mostly hereditary and hence there is little that can be done to prevent its occurrence. However, there are some mild treatments that can be availed of, after the doctor has thoroughly checked your health condition. The common treatment methods for Intrahepatic cholestasis of pregnancy are:

  • Administering anti-itch medicines containing corticosteroids.
  • Weekly blood tests to keep a tab on the bile and bilirubin levels.
  • Administering ursodeoxycholic acid in the form of a medicine, to decrease the concentration of bile acids.
  • Cold baths to reduce the body temperature and rate of blood flowing throughout the circulatory system.
  • Administering vitamin K before delivery and soon after, to prevent causing intracranial haemorrhages.
  • Administering a medically acclaimed steroid called dexamethasone, to increase the immunity and strength of the foetus’ lungs.

These treatments procedures will be followed by the doctors based on the extent of your condition, your body’s tolerance level, and the situation of your pregnancy. This, however, does not guarantee complete success and stoppage of a recurrence. Since Intrahepatic cholestasis is mostly caused due to genes that are passed on, doctors have still been trying to figure out ways to prevent this disease. Till then, all you can do is know the symptoms and get yourself diagnosed as soon as possible. Following this tip will make your situation much easier and less painful to deal with!