Mild itching is a common symptom during pregnancy due to the increased blood amount in the skin. Later, when the belly grows, the abdominal skin stretches pretty much, which may lead to a sensation of itching. When this sensation is mild, you don`t need to worry, but when it becomes more serious, it might be a symptom of liver disease, also known as cholestasis. The affection occurs in less than 1 out of 100 expecting mothers; however, medical care is required.
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What Is Cholestasis?
Cholestasis of pregnancy, known as intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis, represents a potentially severe liver disorder which may develop while pregnant. Typically, the bile sends salts from the liver to the intestine in order to help digest food. When it comes to cholestasis, biliary salts aren`t transmitted in the proper way. There`s no treatment for this condition, but it disappears after birth.
Because of the risk of stillbirth, if you suffer of this illness, you might needs to induce labor or C-section after the week 37 of pregnancy. Typically, the doctors` advice is to give birth in a hospital under professional supervision.
Wearing large clothing items may prevent itching, making it less likely to rub the skin and cause irritations. Also, you should avoid synthetic materials and, instead, choose to wear natural materials, like cotton. They “breathe” and let air circulate near the skin. The application of lotions or creams, or a cold bath may help to soothe this sensation.
There are women who found that products which contain strong odors may irritate the skin, so you might want to try using simple soaps or lotions.
Mild itching isn`t generally harmful for you or your baby! However, sometimes it may be a symptom of a more severe medical condition. If you are concerned, or if the itching sensation is serious, it`s essential to talk to a specialist.
What Is the Cause of Cholestasis?
Doctors haven`t found the exact cause of this medical condition. It`s suspected that the hormonal balance that is characteristic to pregnancy may favor the onset of this illness. It seems that if the women of your family have experienced ICP, the risk of inheriting it is higher.
Also, women who experience liver diseases seem to develop this condition during pregnancy more often. Almost 2/3 of mothers who experienced this medical issue during their first pregnancy will go through it again in their future pregnancies.
The prevalence of this medical condition isn`t known! There are studies that suggest that it affects 1 – 2 pregnancies out of 1,000 in the United States. Other research suggests that up to 1 out of 5 women might develop this illness.
This condition seems to be transmitted in the family, although it may occur even if there aren`t cases in the family. The illness is also more frequent in Indian or Pakistani women.
Rick factors which might increase a pregnant woman`s risk of developing this condition include:
- Carrying a multiple pregnancy, like twins, triplets.
- Being pregnant as a result of IVF.
- Having someone in the family who had this condition.
- Having had this illness in the past, as the risk of recurrence is between 45% – 90%.
What Are the Symptoms of Cholestasis of Pregnancy?
Signs and symptoms of this condition might include:
- Darker urine.
- The “white” of the eyes and skin become yellow.
- Itching on the palms and soles.
- Lighter stools.
In most situations, the intense sensation of itching of the palms and soles represents the only sign manifested by this medical problem. The itching sensation might become harder to bear, especially at night.
We also have to know that the itching sensations caused by ICP are different than the irritations and itching that usually occur during pregnancy around the abdomen. The latter occur as the pregnancy develops and the belly increases its volume.
In turn, the skin itching caused by cholestasis are a lot more intense, especially at night, which can disturb your sleep considerably. If you experience this signs, get in contact with your doctor immediately.
How Does Cholestasis of Pregnancy Affect the Baby?
As already mentioned, the skin itching in the third trimester of pregnancy shouldn`t by all means be ignored. Take good care of you and keep close contact with a doctor as this medical problem can have serious consequences, like the baby being affected by the fact that the bile acids may reach the placental walls and damage the heart, or premature birth. The highest risk of this condition might occur in the week 37 of pregnancy.
Thus, it can often happen for the doctor to decide for birth induction, so that the baby can avoid danger due to this medical issue.
Last but not least, you have to know that the itchy skin cause by this medical illness might not be limited to the soles and palms, and might extend throughout the entire body.
How Do They Test for Cholestasis of Pregnancy?
The diagnosis of obstetrical cholestasis is suspected when an expecting mother complains of itching. Blood tests will outline an increased amount of biliary salts and liver enzymes. However, the blood test results will often appear modified only a week after the symptoms are triggered, so if these tests seem normal, but the signs continue, you`ll be asked to repeat them.
Can Cholestasis Be Treated?
The therapeutic course of this condition will follow 2 aspects:
- Relieving the itching sensation.
- Prevention of any complication.
To relieve itching, the doctor might advise for:
- Specific drugs.
- Lotions or creams that contain corticosteroids that should be applied on the affected areas.
- Placing the soles and palms in warm water.
To prevent the appearance of any fetal complications, your doctor might include:
- Periodic blood tests – to check blood bile salts and liver function.
- Ultrasounds and repeated non-stress tests to evaluate the well-being of the child.
- Labor induction – even if non-stress tests offer normal results, the doctor might still recommend premature labor induction – around the week 38 of pregnancy or earlier if the condition is serious – in order to avoid any complications.