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Cholestasis of Pregnancy

Cholestasis of pregnancy, or intrahepatic cholestasis of pregnancy, is a liver condition that develops during pregnancy. This is a serious condition that needs medical consultation and can possibly lead to a decision of early delivery in order to avoid substantial complications. 

Cholestasis of pregnancy can cause severe itching in one’s hands and feet mostly, but can also be present on other body parts. The peculiar part of this condition is that despite the persistent itching, there are no visible changes or rashes of the skin. 
Mainly, it is due to the reduced or completely blocked flow of bile from the gallbladder.

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    Causes

    Cholestasis of pregnancy is one of those conditions that doctors find no answers to yet. 

    It is thought that some cases are caused by genes, and the condition may run in the family. 

    It is also thought that changes in horomanl levels during pregnancy might trigger this condition, especially in later stages of pregnancy. The rise in pregnancy hormones is associated with the reduction of bile flow from the gallbladder. Bile is responsible for fat breakdown. This results in bile build up in the liver. Bile salts and acids then would enter the bloodstream, causing the itchiness.

    Cholestasis Of Pregnancy Symptoms

    One of the most common symptoms is itching. It can be very severe, and most women report it being concentrated in the hands and feet area. However, others also have itching all over the body. As mentioned before, there is no rash or skin discoloration visible. Itching may get worse during the night, preventing a good night’s sleep. 

    This itching is usually associated with the third trimester but can present earlier sometimes. After delivery, the itching will go away in a couple of days.

    Itching isn’t the only symptom of cholestasis of pregnancy, although it is the main one. Other symptoms may include nausea, loss of appetite, and jaundice (yellow skin and white of the eyes), abdominal pain, and light stool color.

    Complications

    Cholestasis is a major concern for the development of the baby as well as the mother’s health. While healthy issues for the expectant mom do not usually last past pregnancy, the baby’s health problems are much more severe. 

    While being quite rare, cholestasis of pregnancy may cause inhibition of the absorption of fat in the mother’s body, leading to vitamin-K deficiency. This vitamin plays an important role in blood clotting. 

    However, cholestasis of pregnancy effects on babies can be much more pronounced and severe. Firstly, babies might be at risk of early delivery. This may lead to further health complications in life. The baby may be kept in hospital for quite a while after the birth to ensure its safety. 

    The second complication is related to the meconium, a sticky green substance that normally collects in a baby’s intestines, but with cholestasis of pregnancy, can be released into the amniotic fluid. Once there, this substance may access the baby’s lungs, and cause quite significant damage to the lungs and major health issues in life. 

    And thirdly, cholestasis of pregnancy can lead to a stillbirth, with the baby, unfortunately, dying in the late stages of pregnancy.

    Diagnosis

    If you experience itching, it is best to seek medical attention as soon as possible. While this is the most common symptom, your doctor will order some blood tests to see the amount of bile acid in the blood (high if cholestasis of pregnancy is present), and your blood’s clotting reaction time.

    Causes

    Cholestasis of pregnancy is one of those conditions that doctors find no answers to yet. It is thought that some cases are caused by genes, and the condition may run in the family. 

    It is also thought that changes in hormonal levels during pregnancy might trigger this condition, especially in later stages of pregnancy. The rise in pregnancy hormones is associated with a reduction of bile flow from the gallbladder. Bile is responsible for fat breakdown. This results in bile build up in the liver. Bile salts and acids then would enter the bloodstream, causing the itchiness.

    Risk Factors

    Since cholestasis of pregnancy is linked to genes, previously experience individual or family cases are risk factors for developing it again. Carrying multiple babies is also associated with the disease. Any past liver issues and diseases may also contribute to the development of cholestasis of pregnancy.

    Cholestasis Of Pregnancy Diet

    While no specific diet is prescribed as a treatment for this condition, a healthy diet is always a good idea, independent of any disease. Since this is primarily a liver issue, it is advised to reduce the stress load on the liver through diet. This would include reducing fried, spicy, and salty foods. Also, try to limit your food choices to a more balanced diet with organic produce to reduce the toxin processing load on the liver. 

    Treatment

    Depending on the stage of pregnancy, the severity of symptoms, tolerance to various procedures and medicine, and your overall health, your health care team will develop a plan for dealing with this condition as needed. Most of the solutions will focus on relieving the symptoms. Medicine can be prescribed to ease the itchiness and other symptoms. Baby’s health as well as the bile acid levels in the mother’s bloodstream will be regularly and carefully monitored, to identify any complications early on. 

    Ultimately, a decision to deliver the baby early can be made to avoid any long-lasting damage. Delivery can be induced (medical intervention to start the labor process sooner) for vaginal delivery, or a C-section may be ordered.

    Prevention

    Unfortunately, this condition is currently unpreventable.

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