At times, a pregnant woman may experience intense itching, particularly in her hands and feet. This is a common symptom of Intrahepatic Cholestasis of Pregnancy (ICP), a liver disorder that affects a few women, usually during the second half of pregnancy. It is due to the increase in the levels of bile acids in the blood, which in turn affects liver function. Cholestasis in pregnancy is not harmful, but when left untreated, it can lead to severe complications for the baby & mother too. Continue reading to learn more about the causes, symptoms and treatment of intrahepatic cholestasis.
Intrahepatic cholestasis is a liver disorder that affects pregnant women in the later stages of pregnancy, usually in the third trimester. It causes bile acid levels to increase rapidly in the liver and impairs liver function. This consequently leads to elevated bile acid levels in the blood. This condition, characterised by intense itching without rashes, makes you feel uncomfortable and may lead to serious complications for the baby & Mother too.
This complex liver disorder is caused due to a combination of genetic, hormonal and environmental factors. Increased bile buildup in the liver is the primary cause of cholestasis in pregnant women. The other causes of the condition are:
● If you’re suffering from an underlying liver disease or gestational diabetes, then you’re likely to suffer from intrahepatic cholestasis.
● You may suffer from this condition when you're pregnant with more than one baby. You are likely to inherit the condition from your parents or family members so your genes play a key role in getting affected by this condition.
● The spike in pregnancy hormones can reduce the bile flow, resulting in cholestasis during pregnancy.
The symptoms of intrahepatic cholestasis vary from one to another. ICP symptoms include intense itching, nausea, foul-smelling stools, dark urine, yellowing of the skin and eyes, and loss of appetite. The itchiness begins on the palms of the hand and the soles of the feet. The symptoms usually worsen as you're nearing the due date. The symptoms ease after your delivery.
You must consult your doctor to avoid complications when you notice extreme itching during pregnancy. Your doctor asks for your medical history and recommends performing urine tests, blood tests and blood pressure tests. You may also be asked to take a liver function test, bile acid test, and prothrombin time test. These tests are performed to test how your liver functions and bile acid levels in the blood and measure blood clots, respectively. An ultrasound is required to assess the condition of the bile duct and liver, along with fetal ultrasound for baby’s well beign.
Your doctor treats this condition based on your symptoms and delivery time. The primary goal of healthcare providers is to ease itching and reduce the risk of complications. An interprofessional team of doctors usually treats pregnant women with intrahepatic cholestasis. The best and most regular medical care can help ease the symptoms and avoid complications.
Ursodeoxycholic acid, a pregnancy drug, is prescribed to treat intrahepatic cholestasis in pregnant women. This drug can also decrease the risk of preterm birth, stillbirth and low birth weight babies. Your doctor monitors the fetus regularly to assess the growth and avoid complications. Non-stress test, which includes testing your baby’s heart rate, is performed as a part of treatment for cholestasis in pregnant women. A fetal biophysical profile is a series of tests performed to determine the amniotic fluid levels, movement, heart rate, and muscle tone of your baby.
Usually, intrahepatic cholestasis is mild and harmless. However, it can be seriously affecting the baby in the womb. Risks associated with intrahepatic cholestasis are listed below:
● There is an increased risk of early labour due to this liver condition.
● Your baby might suffer from breathing problems.
● Fetal distress is common when you deliver your baby with intrahepatic cholestasis.
● There is also a chance of stillbirth due to higher levels of bile acids in the blood.
● Preeclampsia and gestational diabetes are the other risks of this condition.
● Meconium aspiration and meconium staining of the amniotic fluid are the other risks of cholestasis during pregnancy.
Lifestyle changes can be useful in managing the symptoms of intrahepatic cholestasis. Here are some of the changes that are typically recommended:
● Eat a balanced and healthy diet, including a lot of fruits and vegetables, during pregnancy.
● Avoid eating processed food, sugar and full-fat dairy products.
● Stay hydrated by increasing your fluid intake.
● Wear loose clothing, preferably those made from cotton.
● Use a humidifier to keep your environment moist.
● Ensure your skin is hydrated and moisturised.
● Avoid taking hot showers as it can worsen itching.
● Cool baths and oatmeal baths can ease itching.
● Soaking the itchy areas in lukewarm water eases itching.
It is vital to get an early diagnosis if intrahepatic cholestasis is suspected during pregnancy. The health of both the expectant mother and her baby is at stake. So, make sure to consult qualified healthcare professionals if you notice the symptoms mentioned in this article. With timely intervention, it is quite possible to mitigate the negative effects of this medical disorder, paving the way to a safe and healthy pregnancy journey.
You must consult your doctor when you suffer from itching during pregnancy. If you witness symptoms of ICP, your doctor will recommend getting a bile test, liver function test, prothrombin time test and ultrasound.
It is possible to manage ICP symptoms with simple lifestyle changes, such as:
● Always keep your skin moisturised.
● Eat a balanced and nutritious diet.
● Wear loose cotton clothing.
● Look for ways to relax yourself.
● Take cool baths and oatmeal baths, as these can ease itching.
● Stay hydrated.
Yes, ICP can be harmful to the baby. Your baby may suffer from breathing problems. Other risks of ICP are fetal distress, early labour and stillbirth.
