What is cholestasis?
Obstetric cholestasis of pregnancy, commonly known as cholestasis of pregnancy, is a liver condition that occurs in second and third trimesters of pregnancy. It slows or completely stops the normal flow of bile from the gallbladder. You do have a higher risk of developing cholestasis if you have a family history of cholestasis, history of liver damage/disease or are currently pregnant with multiples. If you have had cholestasis in prior pregnancies your risk of developing it again goes up by about 70%. Cholestasis is suspected to effect 0.1% of pregnancies.
- Intense itching with no rash (often worse at night)
- Jaundice (yellowing of the skin or eyes)
- Loss of appetite
- Pain in the abdomen (uncommon)
- Light stool colour
Your healthcare provider will make a care plan for you based on a numerous number of things including the severity of your condition as well as your overall health and health history. They may choose to deliver between 37 and 38 weeks for safety, however, will deliver preterm (before 37 weeks) if mother or foetus is in imminent danger. If your healthcare providers they will continue the pregnancy, they will schedule a weekly check up to monitor yours and baby’s stability and will increase in frequency the further into pregnancy you get.
- Topical emollients (calamine lotion)
- Information to decrease skin irritation
- Low fat diet
- Increase water intake
- Antihistamines (only use under the guidance of your care time)
- Ursodeoxycholic acid
- Vitamin K
- Dandelion Root and Milk Thistle (do not use natural substances without your care team’s approval)
What are the complications?
- Foetal distress
- Preterm birth
- Meconium in amniotic fluid
- Respiratory issues of baby upon birth
- Stillbirth (rare)
- Inefficient blood clotting (rare – only in mother)
For those in Western Australia, below is a link to the King Edward Memorial Hospital clinical practice guideline on cholestasis. This document will be universal across all West Australian hospitals in their protocols for diagnosing and treating cholestasis.