According to the Pregnancy Association, cholestasis occurs in some women during the last trimester of pregnancy. The severe itching of the hands, feet, legs, and arms that is associated with this condition is caused by a liver disease that is present only during pregnancy. Left untreated, the disease increases risk of fetal distress, possible maternal hemorrhaging, preterm labor, and still birth. Studies show that the highest occurrences of intrahepatic cholestasis are reported among Chilean and Swedish ethnic groups during the colder months of the year.
WHAT CAUSES INTRAHEPATIC CHOLESTASIS?
The cause of intrahepatic cholestasis in pregnancy (ICP) is not known; however, it is believed to be a combination of hormones, genetics, and environmental conditions, as stated in a report from EMedicine.medscape.com.
Increased levels of estrogen in the last trimester, or with multiple births, may increase the chance that a women who is sensitive to estrogen levels might show signs of the condition as her pregnancy progresses.
WHAT ARE THE SIGNS AND SYMPTOMS?
The primary symptom for ICP is severe itching of the hands and feet. In addition patients may experience discoloration in urine and bowl movements, followed by fatigue, depression, and loss of appetite. Other possible symptoms include nausea and jaundice; however, these are not as common.
COMPLICATION ASSOCIATED WITH INTRAHEPATIC CHOLESTASIS
Since genetics are considered to play a role in the cause of this disease, there is an increase in the risk of passing it on to unborn infants, a condition known as Familial Intrahepatic Cholestasis. It is suggested that delivery be induced at 37 weeks when signs of intrahepatic cholestasis are present. Infants born to mothers with the disease may experience difficulty in absorbing fats and vitamins D, E, A, and K, cirrhosis of the liver, and gallstones within the first 10 years of life. Should this happen, a liver transplant may be the only option for curing the disease.
The goal in treating this condition is primarily to relieve the itching through the use of topical ointments with corticosteroids and medications to help decrease the build up bile in the system. Natural substances that are helpful are dandelion root and milk thistle. Bathing in cold water and help to slow the flow of blood in the body, allowing the temperature to lower. Regular blood tests will also help to determine which treatments are working.
Your doctor will need to monitor your symptoms throughout your pregnancy, so be sure to inform her of all symptoms you experience. The ultimate goal is to keep mother and child healthy.