Obstetric Cholestasis (OC) also known as Intrahepatic Cholestasis of Pregnancy (ICP) or Cholestasis of Pregnancy is a very rare medical condition that occurs during pregnancy.
This complication occurs in the third trimester due to the decrease in the flow of bile through bile duct in the liver. Thus bile acid gets built up in the bloodstream causing severe itching, especially on the soles of the feet and palms of the hands. Itching may occur on other parts of the body like belly, breasts, face, back etc. Sometimes, the itching is continuous and becomes unbearable and is even worse during the night.
Causes of Obstetric Cholestasis:
Though the exact causes of obstetric cholestasis are not clear, it is believed that the following factors are responsible for this medical complication.
- Hormones: When a woman gets pregnant, hormones like progesterone and oestrogen increase to a great level. The increase may hinder the passing out of the bile through the bile duct and thus affects the liver causing obstetric cholestasis.
- Genetic factors: Sometimes, genetic factors may also be responsible for the occurrence of obstetric cholestasis. Though some generations may skip this problem, it may occur in the next generation. And if you have suffered from this condition during your first pregnancy, then there is more chance of being affected again.
- Environmental factors: Environmental factors are also thought to play a role in the occurrence of this disease.
- Unbearable itching all over the body without rashes
- Occasionally there may be jaundice
Diagnosis of OC
If the pregnant woman has the potential symptoms of OC, doctors will recommend some tests, including a blood test through which the functioning of the liver along with the levels of bile acids in the blood could be measured.
Effect of Obstetric Cholestasis on the Expectant Mother
Though OC is not very harmful to the expectant mother, in some cases, itching becomes very severe. You may keep awake during nights because of itching, resulting in tiredness and exhaustion. Sometimes, it may take longer to stop your bleeding as the ability of blood clotting may decrease due to the occurrence of OC.
Effect of Obstetric Cholestasis on the Baby
Due to OC in the mother, the baby might pass its first faeces even before birth. This might cause breathing problem in the baby. Rarely, premature delivery might be required.
Treatment of Obstetric Cholestasis
OC usually resolves after birth. Doctors may advise aqueous cream with menthol or calamine lotion which will give you temporary relief and recommend medications. Medications help in minimizing the build up of bile salts in the blood. Delivery may be scheduled prior to your delivery date. After delivery of the baby, the itching will diminish with the passing of time.