Cholestasis of pregnancy
DEFINITION
Cholestasis of pregnancy occurs in late pregnancy and triggers intense itching, usually on the hands and feet but often on many other parts of the body.
Cholestasis of pregnancy can make you intensely uncomfortable but poses no long-term risk to an expectant mother. For a developing baby, however, cholestasis of pregnancy can be dangerous. Doctors usually recommend early delivery.
The term “cholestasis” refers to any condition that impairs the flow of bile — a digestive fluid — from the liver. Pregnancy is one of many possible causes of cholestasis. Other names for cholestasis of pregnancy include obstetric cholestasis and intrahepatic cholestasis of pregnancy.
CAUSES
What causes cholestasis of pregnancy is unclear. There may be a genetic component, as the condition sometimes runs in families and certain genetic variants have been associated with it.
Pregnancy hormones also may play a role. Bile is a digestive fluid produced in the liver that helps the digestive system break down fats. It’s possible that the increase in pregnancy hormones — such as occurs in the third trimester — may slow the normal flow of bile out of the liver. Eventually, the buildup of bile in the liver allows bile acids to enter the blood stream. Bile acids deposited in the mother’s tissues can lead to itching.
SYMPTOMS
Intense itching is the predominant symptom of cholestasis of pregnancy. Most women feel itchy on the palms of their hands or the soles of their feet, but some women feel itchy everywhere. The itching is often worse at night and may be distressing enough that you can’t sleep.
The itching is most common during the third trimester of pregnancy, but sometimes begins earlier. It may feel worse as your due date approaches. Once your baby arrives, however, the itchiness usually goes away within a few days.
Other less common signs and symptoms of cholestasis of pregnancy may include:
- Yellowing of the skin and whites of the eyes (jaundice)
- Nausea
- Loss of appetite
When to see a doctor
Contact your pregnancy care provider promptly if you begin to feel persistent or extreme itchiness.
