If you're pregnant and suddenly experience intense itching, especially on your hands and feet, it could be a sign of a condition called cholestasis of pregnancy (also known as intrahepatic cholestasis of pregnancy or ICP). This condition primarily affects the liver and can cause discomfort and complications, but with proper care and monitoring, both you and your baby can remain safe.
What Is Cholestasis of Pregnancy?
Cholestasis of pregnancy is a liver disorder that occurs in some pregnant women, typically during the third trimester. It happens when the liver's ability to process bile— a substance that helps digest fats—becomes impaired. As a result, bile builds up in the liver and enters the bloodstream, leading to severe itching (pruritus), especially on your hands, feet, and sometimes all over your body.
While it sounds alarming, the condition is temporary, and with proper care, it usually resolves after delivery.
Why Does Cholestasis Happen During Pregnancy?
Hormonal changes during pregnancy, particularly increased levels of estrogen and progesterone, can affect how your liver functions. These changes make it harder for bile to move through your liver and intestines, causing it to back up in your system. Once bile enters the bloodstream, it can trigger that unbearable itchiness.
Some women are more likely to develop cholestasis if they have a family history of the condition, had it in a previous pregnancy, or if they’re carrying twins or multiples.
Symptoms: How Do You Know You Have Cholestasis?
The main symptom of cholestasis is severe itching, often starting on your hands and feet before spreading to other parts of your body. The itchiness tends to be worse at night, and what makes it different from other types of itching is that it doesn’t cause a rash.
Other less common symptoms may include:
- Nausea or vomiting
- Dark urine
- Pale or light-colored stools
- Fatigue
- Loss of appetite
- Pain on the upper right side of your belly
- Yellowing of the skin or eyes (jaundice)
How Is Cholestasis Diagnosed?
If you experience severe itching or other symptoms, your doctor will likely perform a blood test to measure bile acid levels in your bloodstream. Elevated levels of bile acids can confirm the diagnosis. Additional tests like liver function tests or an ultrasound may also be conducted to ensure everything is functioning properly.
Treatment and Management of Cholestasis
The good news is that cholestasis of pregnancy can usually be managed with medication. A common treatment is ursodeoxycholic acid (UDCA), which helps improve liver function and reduces bile acids in the blood. Your doctor will give you proper course of medication after proper tests.
Other ways to manage symptoms include:
- Anti-itch medications (after consulting with your doctor)
- Wearing loose, comfortable clothing to avoid irritating your skin
- Taking warm baths to soothe itching
- Resting and avoiding stress
If medications aren’t effective or bile levels remain too high, your doctor may recommend delivering the baby early (usually around 37-38 weeks). This can help prevent potential complications for both you and your baby.
Potential Complications for You and Your Baby
While cholestasis itself isn’t usually life-threatening, it can cause some serious complications if left untreated:
For you: You may have trouble absorbing vitamin K, which can increase the risk of heavy bleeding after delivery. There’s also an increased risk of preeclampsia (high blood pressure) and gestational diabetes.
For your baby: Cholestasis can lead to premature birth, stillbirth, or fetal distress. Sometimes babies may inhale meconium (a thick substance found in the intestines) during delivery.
Can You Have a Healthy Baby with Cholestasis of Pregnancy?
Yes! Many women with cholestasis go on to deliver healthy babies, especially with early monitoring and careful management. Your doctor will monitor the baby’s health closely, including using tests like a non-stress test or biophysical profile.
Foods to Eat or Avoid During Cholestasis of Pregnancy
While there’s no specific diet for cholestasis, a balanced diet is always recommended during pregnancy. Focus on eating a variety of foods, especially fruits, vegetables, lean meats, and protein-rich foods. Your doctor may suggest avoiding certain foods, depending on how your liver is functioning.
Can Cholestasis of Pregnancy Be Prevented?
Unfortunately, there’s no way to prevent cholestasis, especially if you have a genetic predisposition or have experienced it in a previous pregnancy. However, knowing your risk factors can help you prepare and monitor symptoms early on.
What Are the Long-Term Effects?
Cholestasis of pregnancy typically disappears a few days after you give birth, and your liver function usually returns to normal. However, if you’ve had cholestasis once, there’s a higher chance it could happen again in future pregnancies. In fact, about 60% of women who have had cholestasis in one pregnancy will experience it again in a subsequent one.
When to Contact Your Doctor?
If you notice severe itching that doesn’t subside or if you develop yellowing of your skin or eyes, it’s important to reach out to your healthcare provider right away. Early diagnosis and management can help minimize the risk of complications for both you and your baby.
If you have any concerns or experience unusual symptoms, don’t hesitate to reach out to your doctor. They’re there to support you and ensure you and your baby are well taken care of throughout your pregnancy.
