Cholestasis is a condition in pregnancy that affects the liver. During pregnancy, the liver can become over-sensitive to hormones. The main symptom is itching, but jaundice has also been associated with cholestasis. Generally, this condition goes away soon after the birth of the baby.
Causes of Cholestasis
The liver produces bile, which flows down the bile ducts into the intestines and helps with food digestion. With cholestasis, the flow of bile into the intestines is reduced, causing bile salts to build up in the blood. Treatment will be required to return liver function and bile acid results back to normal.
Itchiness is the main symptom of cholestasis, which tends to become worse at night. It usually starts on the hands and feet, and then progresses on other areas of the body. Women suffering from this itching may scratch so abrasively that the skin may start to bleed. This itchiness should disappear soon after the baby is born.
Symptoms of Cholestasis
Aside from extreme and obvious itchiness, there are other symptoms that can indicate cholestasis. These include:
- Light colored stool
- Dark colored urine
- Fatigue
- Jaundice
- Nausea
- Loss of appetite
- Depression
Risk Factors
This condition affects approximately 1 out of 1,000 pregnancies. It seems to be more prominent in Chile for some reason, and less common in Europe. A family history of cholestasis will increase a woman’s risk of developing this condition in pregnancy. Women who have previously carried multiples or had previous liver damage may also be more susceptible to developing cholestasis in pregnancy. If a woman develops this condition, her chances of developing cholestasis in subsequent pregnancies is 60% to 80%.
Diagnosing Cholestasis
A blood test will include a bile acid test and a liver function test. This should give an indication if the itchiness the mother is experiencing is related to cholestasis. If the test comes back negative, it should be repeated in case it was too early to test. Women may itch for a while before they test positive for cholestasis.
Dangers of Cholestasis on the Baby
Certain risks are placed on the baby when the mother suffers from cholestasis. Since the baby relies on the mother’s liver to remove bile acids from the blood, there is an increased amount of stress on the baby’s liver if the bile is not being removed from the body efficiently. There is a risk of the bile acids crossing the placenta, and a risk of reduced oxygen to the baby. As such, a baby under these conditions has a higher risk of fetal distress, preterm birth and stillbirth.
Treatment
In the past, cholestasis was treated with a medication called Cholestyramine. Nowadays, this medication is not readily used anymore as its effectiveness is not considered as great as other treatments. In addition, there may be adverse side effects associated with this medication.
Options for treatment of cholestasis, or the itchiness in particular, include:
- Medication to reduce bile acids
- Vitamin K to prevent hemorrhaging
- Topical anti-itch medication
- Cold baths to slow down the flow of blood
- Dandelion Root and Milk Thistle
- Regular blood tests to monitor the bile serum levels
For more pregnancy-related information, please visit: www.complete-pregnancy-guide.com
References:
1. American Pregnancy Association
2. emedicine.medscape.com
3. encyclopedia.com
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