I'm 33 weeks pregnant and was just diagnosed with cholestasis. What will this mean for me and my baby?
Cholestasis is condition that can occur as a result of pregnancy hormones. These hormones can affect the flow of bile in the gallbladder. Bile is a substance in your body that helps with the breakdown of fats and is stored in the gallbladder (although it is made by the liver). When bile slows down or gets backed up in the liver, it can spill out into the blood stream. The excess levels of bile acids can cause several different symptoms.
One of the most common (and annoying) symptoms from cholestasis is itchiness. Many women will experience intense itching, especially on the soles of the feet and palms of hands. Another condition of pregnancy that can cause intense itching is called PUPPPs, which is associated with a rash (however cholestasis is not).
Symptoms of cholestasis include:
- Extreme fatigue
- Dark urine color
- Loss of appetite
- Bowel movements that are lighter in color
- Pain in the upper right quadrant of the abdomen
- Jaundice (yellowing of the skin)
The March of Dimes reports that only about one percent of women in the United States will be afflicted with cholestasis. It appears to be more common in women with a family history (mother or sisters who have had cholestasis) or women carrying multiples. In 2000, The Journal of Hepatology reported that up to 60 percent of women with cholestasis can deliver prematurely (before 37 weeks gestation). Your doctor will diagnose you by doing a physical examination, listening to your symptoms and history, and drawing blood to assess liver function. Sometimes topical anti-itch medication may be used to provide comfort and relief. Treatment may include the use of a medication called ursodeoxycholic acid (Actigall). If you are taking the medication, your doctor will monitor you and your baby closely with more frequent appointments and ultrasounds. If symptoms are severe, your doctor may opt to induce labor. If induction is to be before 37 weeks, your physician may do an amniocentesis to determine the maturity of your baby's lungs. Cholestasis will usually clear up a few days after delivering your baby.