understanding obstetric cholestasis in pregnancy

Many women feel itchy when they’re pregnant and normally it's nothing to worry about. Occasionally though, that itching can be a sign of a condition called obstetric cholestasis. Here's what you need to know about this rare condition.

what is obstetric cholestasis?

Obstetric cholestasis is also known as intrahepatic cholestasis. It’s a liver condition that affects around one in every 140 pregnant women in the UK. Put simply, what happens is that the bile that should flow from your liver to your gut, instead builds up in your body.

do i have obstetric cholestasis?

The main symptom of obstetric cholestasis in pregnancy is intense itching. Of course, a little itching on your bump is normal. With obstetric cholestasis though, you'll mainly feel it on your hands and feet, or all over. For some, the itching can be milder, so it’s worth knowing the other symptoms of obstetric cholestasis too. These include:

  • itching
  • darker wee
  • lighter coloured poo
  • yellowing of the skin and whites of your eyes

Not everyone will have all of these symptoms. If you’re at all worried, it’s best to have a word with your GP.

am i at risk of obstetric cholestasis?

Any pregnant woman can get obstetric cholestasis. However, it does affect some women more often than others. Risk factors include:

  • your family history
  • suffering from obstetric cholestasis in a previous pregnancy
  • coming from a South American, Scandinavian, Indian or Pakistani background
  • carrying twins or triplets
  • having hepatitis C
  • taking progesterone, including high-dose oral contraceptives

is obstetric cholestasis dangerous?

Sadly, women who have obstetric cholestasis do have a slightly greater risk of their baby being born prematurely, or stillborn. It’s believed the risk of stillbirth is between one and five percent. It's worth remembering that the vast majority of babies are born healthy though. The main thing is to get tested. If your medical team know you have obstetric cholestasis, they can make sure you get the best care possible.

what’s the treatment for obstetric cholestasis?

Your doctor will arrange for you to have your blood tested regularly so they can keep an eye on your bile acid levels. You might be prescribed ursodeoxycholic acid, which can help to reduce bile acids and ease the itching. In some cases, you’ll be given a Vitamin K supplement. There's also a chance labour may be induced earlier than expected.

is there anything i can do to stop the itching?

There are things you can do to ease the itching. These include:

  • wearing looser clothing
  • choosing natural fabrics, eg cotton, over synthetics
  • using non-perfumed shower gel and body lotion etc
  • having a cold bath
  • using a cream that’s safe to use in pregnancy, such as aqueous cream with menthol
  • Thankfully, the itching should disappear pretty quickly after you’ve had your baby.