What is cholestasis of pregnancy?

Cholestasis of pregnancy is a common liver disease that causes severe itching late in pregnancy. It is also known as intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis.

ICP temporarily impairs (lowers) liver function in some pregnant women. This liver impairment causes bile (a substance made by the liver that helps digestion) to build up in the liver and bloodstream. When levels of bile in the blood reach a certain point, it causes the itching.

Cholestasis of pregnancy can cause complications for both the expectant mother and baby.

How common is cholestasis of pregnancy?

Cholestasis is a common liver disease during pregnancy. About 1 to 2 in 1,000 pregnant women develop ICP. Women with Scandinavian, Indian, Pakistani or Chilean backgrounds are more likely to develop it.

What causes cholestasis of pregnancy?

Bile is a substance made by the liver. It helps break down fats during digestion. In some people, when levels of hormones such as estrogen increase during pregnancy, the flow of bile in the liver stops or slows down. This slowdown can cause bile to build up in the liver and enter the bloodstream.

Cholestasis of pregnancy typically develops in the third trimester when pregnancy hormone levels are at their highest. In some cases, it is genetic, meaning it is passed down among family members.

What are the symptoms of cholestasis of pregnancy?

The main symptom of cholestasis of pregnancy is severe itching (pruritus). This itching starts on the hands and feet and spreads to other parts of the body. Itching is usually worse at night. It does not involve a rash.

Less-common signs of obstetric cholestasis may include:

  • Nausea
  • Dark urine
  • Light-colored stool
  • Fatigue (extreme tiredness)
  • Decreased appetite
  • Pain in the upper right belly
  • Jaundice (yellowing of the skin and eyes)

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