There are many changes that occur to your body throughout pregnancy, some good and some that we should be aware of. If you start to experience intense itching without a rash on your hands and feet, it may be time for a trip to your health practitioner.
Cholestasis is a condition that affects your liver late in pregnancy, typically in the third trimester. It affects about 1 in 1000 pregnancies (less than 1%). The exact cause remains unclear however it impacts the livers’ ability to deliver bile to the small intestine. Bile accumulates in the liver in which it then enters the bloodstream. When this happens, it causes the following symptoms:
- Intense Itching on the palms of your hands or soles of your feet
- Yellowing of the skin
- Nausea
- Loss of appetite
- Foul smelling stool
Health professionals believe that pregnancy hormones and genes may play a role in developing cholestasis. There are however certain factors that can increase your risk such as:
- Family history
- History of liver damage or disease including hepatitis C
- Gallstones
- Multiple pregnancy
- Increased BMI
- Pregnant >35 years of age
It is extremely important to identify these symptoms early as it has consequences for mum and growing bub. Cholestasis has a small risk of ongoing liver complications after pregnancy but are rare. It may also increase the risk of developing preeclampsia and gestational diabetes.
Complications for the bub include:
- Premature birth
- Lung problems
- Infant mortality or stillbirth
Your doctors will work with you to help treat cholestasis. The goals of therapy are to help soothe the itching. Doctors can use medications and will monitor blood bile acid and liver levels to ensure bub can safely reach full term. Regular check-ins with your obstetrician throughout your pregnancy gives you plenty of opportunity to bring up new symptoms that raise concern. When in doubt it is always safest to get a second opinion.
References
Gardiner FW, McCuaig R, Arthur C, Carins T, Morton A, Laurie J, Neeman T, Lim B, Peek MJ. The prevalence and pregnancy outcomes of intrahepatic cholestasis of pregnancy: A retrospective clinical audit review. Obstet Med. 2019 Sep;12(3):123-128. doi: 10.1177/1753495X18797749. Epub 2018 Oct 25. PMID: 31523268; PMCID: PMC6734627. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734627/