Cholestasis of pregnancy is a liver condition that sometimes happens in the third trimester. The main symptom is extreme itchiness in the hands and feet. A lot of times, this is the only symptom that you'll notice. Pregnancy hormones can sometimes overload the liver, and this blocks the flow of digestive fluid (bile) in the gallbladder and leads to cholestasis. It affects about one out of every 1,000 women, but it shows up more frequently in women of Chilean or Swedish descent.
Cholestasis is a serious condition that can affect the baby's liver as well as the mother's. It can lead to fetal distress or even stillbirth in the worst case scenario. Doctors will often recommend inducing labor as soon as the baby's lungs have developed, in order to keep both mom and the baby safe.
Symptoms of Cholestasis
- Itchy hands and feet
- Loss of appetite
- Dark colored urine or lighter colored stools
- Fatigue or exhaustion
Sometimes women with cholestasis will experience nausea, which should normally subside by the third trimester. A jaundiced appearance (yellowing in the whites of the eyes) can also develop, since the liver is affected. Some women have reported pain in the upper right quadrant of the body as well.
What Causes Cholestasis of Pregnancy?
Cholestasis happens when the gallbladder stops functioning properly. Your liver produces bile, which is stored in the gallbladder. The bile is what breaks down fats during the digestive process. Pregnancy hormones can interfere with the function of the gallbladder, which in turn leads to cholestasis. The hormones slow down or stop the flow of bile. This makes the liver become overloaded with bile, and eventually it releases it into the mother's bloodstream.
How Is Cholestasis of Pregnancy Treated?
There are a variety of medicinal and other treatments that a doctor will prescribe to help a mother deal with cholestasis, and hopefully help her carry the baby to full term. Treatment starts with corticosteroid creams to try to get the itching to stop. Ursodeoxycholic acid and other medications may be prescribed to try to reduce the concentration of bile acids in the mother. Steroid treatments like Dexamethasone may be administered, which will help the baby's lungs to mature faster.
Many doctors will recommend natural herbal treatments like dandelion root and milk thistle. These herbs have properties that help the liver to cleanse itself better. Decreasing the temperature of the mother's blood is another goal of treatment, so cold baths and ice water will be recommended. Vitamin K supplements are given to the mother prior to delivery to help prevent intracranial hemorrhaging.
The doctor will monitor the mother's progress throughout the treatment. This may involve regular blood tests to check liver readings and non-stress testing like fetal heart monitoring.
There is some debate in the medical community over whether cholestasis of pregnancy is likely to occur in subsequent pregnancies. There is some research that suggests there is a strong chance that the condition will return if a woman gets pregnant again.