The most common cause of severe itching late in pregnancy is
cholestasis, a common liver disease that only happens in pregnancy. Cholestasis of pregnancy is a condition in which the normal flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones. Other names of cholestasis are extrahepatic cholestasis which occurs outside the liver, intrahepatic cholestasis which occurs inside the liver, or obstetric cholestasis.
Cholestasis can happen anytime in pregnancy but is more common in the last trimester of pregnancy when hormones are at their peak, but it usually goes away within a few days after delivery. Cholestasis occurs in about 1 out of 1,000 pregnancies but is more common in Swedish and Chilean ethnic groups.
Causes of Cholestasis of pregnancy
Pregnancy hormones affect gallbladder function, resulting in slowing or stopping the flow of bile. The gallbladder holds bile that is produced in the liver, which is necessary in the breakdown of fats in digestion. When the bile flow is stopped or slowed down, this causes a build up of bile acids in the liver which can spill into the bloodstream.
Symptoms of Cholestasis of pregnancy
The following women have a higher risk of getting cholestasis during pregnancy:
How is Cholestasis of pregnancy diagnosed?
A diagnosis of cholestasis can be made by doing a complete medical history, physical examination, and blood tests that evaluate liver function, bile acids, and bilirubin.
How will the baby be affected if the mother is diagnosed with Cholestasis?
More often than not, cholestasis will have no adverse effect on the pregnancy though it may increase the risks for fetal distress, preterm birth, or stillbirth. Women with cholestasis should be monitored closely and some doctors like to deliver the baby, especially close to the due date. Many doctors will monitor the pregnancy closely with tests such as regular non-stress tests which involve fetal heart monitoring. In addition, regular blood tests are done to monitor both bile serum levels and liver function
What is the treatment for Cholestasis of pregnancy?
The treatment goals for cholestasis of pregnancy are to relieve itching. Some treatment options include:
Treatment for cholestasis of pregnancy needs to be determined by your physician who will take the following criteria into consideration:
Recurrence in another pregnancy
Some sources claim that women who have had cholestasis of pregnancy have up to a 90% chance of having this repeat in future pregnancies.