Pregnancy cholestasis is a liver condition that develops in the later part of pregnancy and may raise bile levels which could impact the developing foetus.
Pregnancy is a life-changing experience and while one should enjoy each and every day of the crucial phase, it is at the same time important to pay attention to your body and take note of symptoms that may appear at every stage. It is not just the gestational diabetes or blood pressure that could create complications for expecting mothers and the unborn baby, there are a number of health conditions that may have subtle signs which could go unnoticed. Pregnancy cholestasis or Intrahepatic cholestasis of pregnancy (ICP) is one such liver condition that commonly develops during the second or third trimester and the expecting mother may experience itching on hands or feet, yellowing of the skin, and eyes, nausea, loss of appetite, foul smelling stools among other symptoms. While bile acids usually aid in digestion, but in this condition, they accumulate in the body instead.
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What is pregnancy cholestasis?
“Pregnancy cholestasis is a liver condition. It reduces or completely prevents the normal flow of bile from the gallbladder. There is itching and yellowing of the skin, eyes, and mucous membranes (jaundice). Cholestasis can develop early in pregnancy. However, it is more prevalent in the second and third trimesters. It usually disappears after a few days of birth. High bile levels might pose major difficulties for your growing baby (foetus),” Dr Payal Narang, Consultant Obstetrician & Gynaecologist, Motherhood Hospital Lullanagar, Pune told HT Digital.
What happens when one gets cholestasis during pregnancy
“A foetus relies on the liver to eliminate waste from its blood throughout the pregnancy. If your liver isn’t working correctly, bile levels may rise to dangerous levels, stressing the foetus’s liver. Because the liver is a vital organ responsible for eliminating waste from your body, its malfunction can lead to issues. Your prenatal care provider will continuously watch you to ensure that cholestasis does not affect you or the foetus,” says Dr Narang.
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What causes pregnant itching?
There could be other reasons behind itching during pregnancy also, and it could range from skin stretching, dryness, or hormonal chances.
There are several reasons why you may have itching when pregnant. These might include:
1. Skin stretching: Skin stretches far more than it is used to, throughout first pregnancy and repeated pregnancies.
2. Dryness: Pregnancy hormone fluctuations can produce itchy, flaky, dry skin.
3. Fabrics or perfumes: Different materials and substances can physically irritate you.
4. Hormones: Pregnancy hormone changes can influence anything from mood to circulation to, yep, itching.
5. Cholestasis: This is a liver condition that can induce an accumulation of bile acids in the blood, causing itching.
6. Prurigo: These crusty, itchy pimples that can occur on the arms, legs, or belly at any stage of pregnancy.
It is critical to analyse where on your body you are itching. Because the epidermis in these regions is changing so rapidly during pregnancy, most pregnancies will result in aching belly and irritated breasts.
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How is ICP identified?
“Intrahepatic cholestasis of pregnancy (ICP) is normally diagnosed by ruling out other possible reasons of itching. You may be offered liver function tests (LFTs) and bile acid testing if you experience unexplained itching. This exam does not require you to fast,” says Dr Narang.
“Some women may experience itching for several days or weeks before their tests are abnormal. If the itching persists and there is no obvious explanation, the bile acids and LFTs should be checked every 1-2 weeks. It is quite possible that your healthcare provider is unfamiliar with ICP,” says the expert.
Risks associated with pregnancy cholestasis
If you have pregnancy cholestasis, your growing baby is at risk of significant issues. Dr Narang explains the complications:
Distress in the foetus: This indicates that your developing baby is not performing properly. For example, the newborn might be deficient in oxygen.
Premature birth: You may be at a higher risk of delivering too soon.
Meconium-stained liquor: This indicates that your baby had a bowel movement just before delivery. This might result in severe respiratory issues.
Breathing (respiratory) difficulties: As a newborn, your infant may experience respiratory difficulties.
Pregnancy cholestasis can potentially result in vitamin K insufficiency. This must be addressed before delivering since it might cause excessive bleeding.
How to avoid itching during pregnancy
Although you may not be able to completely avoid itchy skin during pregnancy, the following methods suggested by Dr Narang may help:
• Shower and bathe in lukewarm water. Hot water can dry out your skin and aggravate irritation. (It’s advisable to avoid super-hot showers anyhow when pregnant.) Use a moderate, fragrance-free soap and thoroughly rinse it off. Dry yourself carefully with a towel.
• Maintain as much calm as possible. Avoid staying outside for long amounts of time throughout the day since heat (and overheating) can aggravate irritation.
• Dress comfortably. Loose cotton clothing protects your skin from irritation.
• Moisturize. After a shower or bath, use fragrance-free lotion or cream. Keep lotion in the refrigerator to make moisturising your skin feel chilly.
• Reduce your tension. Take measures to lessen stress and worrying when pregnant, while seemingly unrelated, stress can actually worsen the itch.
