Cholestasis of Pregnancy – Symptoms and Causes
Overview
Intrahepatic cholestasis of pregnancy affects the liver during the later stages of pregnancy. This condition causes severe itching without any visible rash. Most women experience itching on their hands and feet, though it can spread to other body parts.
The real concern lies in the potential risks to the unborn baby. Due to these complications, healthcare providers often recommend delivering the baby early, typically around 37 weeks of pregnancy.
The condition requires medical attention and monitoring to ensure both mother and baby remain healthy throughout the remainder of the pregnancy.
Signs and Discomfort
The main symptom of pregnancy cholestasis is severe itching without any visible rash. This itching typically affects the palms of hands and soles of feet, but can spread to other parts of the body.
Many women find the itching worsens at night, often disrupting sleep patterns.
Itching most commonly develops during the third trimester, though it may start earlier for some women. The discomfort often intensifies as the pregnancy progresses toward delivery. Fortunately, symptoms typically resolve within days of childbirth.
Some women may experience additional symptoms, including:
- Jaundice (yellowing of skin and eye whites)
- Feeling sick to the stomach
- Reduced hunger
- Greasy, bad-smelling bowel movements
Medical Attention Needed
If you experience constant or extreme itching during pregnancy, contact your healthcare provider immediately. This symptom should not be ignored, as early detection and management can help protect both mother and baby.
Your doctor can perform tests to determine if cholestasis is causing your symptoms.
Causes
Cholestasis of pregnancy occurs when bile flow slows down or stops completely. While doctors don’t know the exact reason this happens, several factors likely contribute to the condition.
Pregnancy hormones appear to play a significant role. As hormone levels increase in late pregnancy, they can interfere with normal bile movement through the liver.
This disruption causes bile acids to build up in the liver and eventually leak into the bloodstream.
Genetic factors may increase susceptibility to cholestasis. Some families show patterns of the condition across generations, and researchers have identified specific genetic variations linked to this liver disorder.
Environmental influences also affect risk, though specific factors remain unclear. The likelihood of developing cholestasis varies by:
- Geographic location
- Season of the year
These patterns suggest that something in a person’s surroundings might trigger the condition in those who are already predisposed to it.
Risk Factors
Several factors may raise your chance of getting cholestasis during pregnancy:
- Personal or family history of the condition
- Previous liver problems including hepatitis C or gallbladder stones
- Multiple babies (twins, triplets, etc.)
- Pregnancy after age 35
If you’ve had cholestasis in a previous pregnancy, your chances of experiencing it again are quite high. About 60-70% of women will develop it in later pregnancies.
For those who had severe cases, the risk of it happening again may reach up to 90%.
Complications
Cholestasis of pregnancy can lead to several health risks, primarily due to elevated bile acid levels in the bloodstream. While mothers may face some issues, developing babies face the most significant dangers.
For pregnant women, cholestasis can temporarily disrupt fat absorption, which might reduce blood-clotting factors that depend on vitamin K. This is uncommon but possible. Women with this condition also have higher chances of developing:
- Preeclampsia (high blood pressure during pregnancy)
- Gestational diabetes
Babies face more severe risks when their mothers have cholestasis:
| Complication | Description |
|---|---|
| Preterm birth | Being born earlier than 37 weeks of pregnancy |
| Lung problems | Caused by inhaling meconium (baby’s first stool) that passed into the amniotic fluid |
| Stillbirth | Death of the baby in the womb before delivery |
Because of these serious risks, especially stillbirth, healthcare providers often recommend inducing labor before the due date. This early delivery helps protect the baby from the harmful effects of high bile acid levels.
While future liver problems are possible for women who experience cholestasis during pregnancy, they aren’t common.
Prevention
Currently, there is no known method to prevent cholestasis during pregnancy. Medical research has not yet identified specific actions that can reliably prevent this liver condition from occurring during pregnancy.
