Cholestasis in pregnancy, also known as intrahepatic cholestasis of pregnancy (ICP), affects the liver’s ability to process bile. This condition often develops in the third trimester when hormone levels are at their peak. Hormones, particularly estrogen, may slow bile flow, causing it to build up in the liver and spill into the bloodstream.
The most common symptom of cholestasis is intense itching, especially on the hands and feet. This itching can occur without a rash and often worsens at night. Other symptoms include dark urine, pale stools, and fatigue. In rare cases, jaundice, or yellowing of the skin and eyes, may appear.
Cholestasis may increase risks for both the mother and baby. For mothers, the itching can cause significant discomfort and disrupt sleep. For babies, risks include preterm birth, meconium-stained amniotic fluid, and, in rare cases, stillbirth.
Doctors diagnose cholestasis through blood tests that measure bile acid levels and liver function. High bile acid levels confirm the condition. Early diagnosis helps reduce risks to the baby and mother.
Managing Cholestasis in Pregnancy
Treatment focuses on relieving symptoms and reducing risks to the baby. Ursodeoxycholic acid is a common medication that lowers bile acids and eases itching. Your doctor may also recommend antihistamines for mild itching, though they do not treat the cause.
Frequent monitoring ensures the baby’s safety. Your doctor may perform non-stress tests and biophysical profiles to check fetal health. These tests monitor the baby’s heart rate, movements, and breathing patterns.
Delivery often occurs early to prevent complications. Most doctors recommend inducing labor around 37 weeks if bile acid levels remain high. For some women, earlier delivery may be necessary.
Lifestyle changes can help manage symptoms. Avoid hot showers, as they can worsen itching. Wearing loose, cotton clothing may reduce irritation. Some women find oatmeal baths or cold compresses soothing.
Cholestasis symptoms usually disappear after delivery. Follow-up tests ensure liver function returns to normal. Women who have had cholestasis in one pregnancy may experience it again in future pregnancies.
If you suspect cholestasis, contact your doctor right away. Early treatment protects both you and your baby. Regular prenatal care and open communication with your healthcare provider are essential.