Mother and Baby

Pregnancy Health A-Z: Obstetric Cholestasis  

Pregnancy Health A-Z: Obstetric Cholestasis

Itchy skin is hugely annoying at the best of times, but it can be the sign of something serious in pregnancy and needs to be checked out by a doctor

Feeling itchy during pregnancy is relatively common, as your skin is stretching all over and it can be uncomfortable.

But in some cases, itchiness could point to a potentially serious liver disorder that can develop when you're pregnant – obstetric cholestasis.

What is it?  

Obstetric cholestasis (OC) is liver disorder that’s unique to pregnancy. It occurs when the bile salts that normally flow from your liver to your gut to help you digest your food, don’t flow properly and build up in your system.

It doesn’t tend to present any symptoms until the last trimester.

‘OC does seem to run in families,’ says Dr Michael Heard, consultant obstetrician. ‘If you’ve had OC in a previous pregnancy, you’re more likely to develop it again in a subsequent pregnancy.’

What are the symptoms?  

As you would expect, the main symptom of OC is severe itching, particularly on the palms of your hands.

The main symptom of OC is severe itching, particularly on the palms of your hands

Itching is really common during pregnancy – and often associated with stretch marks – so, before self-diagnosing, it's important to go and see your GP immediately. She may order a blood test to find out for certain (called a Liver Function Test).

‘In more severe cases, jaundice may also be a sign,’ says Dr Heard. ‘And dark urine, rashes and pale bowel movements may also be indications.’

How is it treated?  

You will have regular tests and your doctor will monitor your condition. 'She may prescribe a drug that binds your bile acids in the bowel,’ says Dr Heard. ‘This drug will sit in the bowel and won’t affect your baby.’

You may also be offered a vitamin K supplement as OC can affect the absorption of the vitamin in your body and it is important for blood clotting. There are also some at-home remedies that you can try to relieve your itching. Take cool baths, and use creams such as calamine lotion – but check with your pharmacist that anything you use is safe during pregnancy.

All signs of the OC should disappear once you’ve had your baby – if they don’t then you may have been mis-diagnosed and your GP will explore other reasons behind your itching.

Is there a risk to the baby? 

There is a risk that the baby could be premature or stillborn. But it isn’t known if the two are directly linked. Because of this, you may be offered an induction or C-section after 37 weeks.

‘This will only be done if your baby is almost full-term,’ Dr Heard explains. ‘And your baby will be given medicine to help his lungs develop as they should.’

Even if you aren’t induced, it’s advised you give birth in a hospital with a medical team on standby.

Regardless of how severe your OC is, you will be checked frequently, monitored and treated throughout your pregnancy to make sure that both you and your baby stay safe.

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