Liver and Liver Diseases

What is the Cholestasis of Pregnancy? 6 Key Points to Note

Last updated on October 20th, 2022 at 07:57 am

The Cholestasis of Pregnancy

Cholestasis of pregnancy is a liver problem. It slows or stops the normal flow of bile from the gallbladder. This causes itching and yellowing of your skin, eyes, and mucous membranes (jaundice). Cholestasis sometimes starts in early pregnancy. But it is more common in the second and third trimesters. It most often goes away within a few days after delivery. The high levels of bile may cause serious problems for your developing baby (fetus).

What are the symptoms of cholestasis of pregnancy?

The major symptom of cholestasis of pregnancy is severe itching. This is sometimes called pruritus. It may be all over the body. But it is more common on the palms of the hands and soles of the feet. It may also be worse at night. Other symptoms may include:

  • Pain in the belly (abdomen), although this is not common
  • Light color of stool (bowel movements)
  • Yellow color of skin, eyes, and mucous membranes (jaundice), although this is not common

The symptoms of cholestasis sometimes look like other health conditions. Always see your doctor for a diagnosis.

How is the cholestasis of pregnancy diagnosed?

Your doctor is likely to think you have cholestasis of pregnancy if you have severe itching. Lab tests will help to confirm the diagnosis. You may have these tests:

  • Liver function tests, including the amount of bile acid in the blood. This test result is high in cholestasis of pregnancy.
  • Other lab tests, including prothrombin time. This checks how well your blood clots.

You may also have other tests, such as an ultrasound exam of the tubes that carry bile (bile ducts).

How is the cholestasis of pregnancy treated?

The goals of treating cholestasis of pregnancy are to relieve the itching and prevent complications. Treatment may include:

  • Medicine. To help relieve itching and help lower the level of bile.
  • Measuring serum total bile acid. The level of bile in your blood may be checked. This helps your doctor figure out treatment.
  • Fetal monitoring. The doctor may check your developing baby for any problems.
  • Premature delivery. You may deliver your baby early, between 37 to 38 weeks of pregnancy. This will lessen the risk to your baby. This may be by vaginal delivery with medicine to start labor. Or you may have a cesarean delivery. Your doctor may decide that you should deliver even earlier, depending on your symptoms, test results, and pregnancy history.
What are the potential complications of cholestasis of pregnancy?

There is a serious risk of complications in your developing baby if you have cholestasis of pregnancy. The complications include:

  • Fetal distress. This means your developing baby is not doing well. For example, the baby may not be getting enough oxygen.
  • Preterm birth. You may be at greater risk of giving birth too early.
  • Meconium in amniotic fluid. This means your baby has a bowel movement before birth. This may cause very serious breathing problems.
  • Breathing (respiratory) problems. Your baby may have breathing problems as a newborn.

Cholestasis of pregnancy can also lead to vitamin K deficiency. This will need to be treated before you give birth, because it can cause you to bleed too much.

6 Key Points to note, identify and treat cholestasis of pregnancy
  1. Cholestasis of pregnancy is a condition that slows or stops the normal flow of bile in the gallbladder.
  2. It can cause severe itching. This is the most common symptom.
  3. The goals of treating cholestasis of pregnancy are to relieve itching and prevent complications for your developing baby.
  4. Babies of women with cholestasis are often delivered early (usually around 37 weeks) because of the risks.
  5. Call your doctor or visit his/her clinic if you have severe itching
  6. Yellow coloring of your eyes, skin, or mucous membranes (jaundice) are early symptoms

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