A Disease Specific to Pregnancy
Intrahepatic Cholestasis of Pregnancy or Obstetric Cholestasis, is a liver disease that is specific to pregnancy. Many times, the only symptom that occurs is itching, particularly on the hands and feet.
The itching disappears within a week or two of delivery and is not thought to cause long-term problems for the mother. However, ICP does pose an increased risk to the baby if it is not recognized and treated properly.
The itching commonly starts in the last trimester of pregnancy, but it can begin sooner. It can be very severe for the mother, but the greater risk is to the unborn baby who should be delivered early, around 35-38 weeks, to prevent the possibility of stillbirth.
Other pregnancies for the same mother may require an earlier delivery than the first baby, as the disease seems to increase in intensity in subsequent pregnancies.
Much research on ICP is still needed to determine the exact causes and risks of this disease. It is thought that the high levels of estrogen produced during pregnancy cause a reduction of bile flow. This reduction of bile flow creates a buildup of bile salts in the blood. For the mother, this means itching and sometimes jaundice. For the baby, it appears the buildup of bile salts poses a danger that becomes greater after 35-37 weeks, which can result in stillbirth.
It is essential that a woman who feels that she is itching more than normal seeks professional help and does not stop until she is properly evaluated. This usually means having a doctor take a blood sample for evaluation of the liver functions (LFT’s). If liver functions are abnormal, and only after ruling out all other diseases and disorders (AIDS, primary liver disease not caused by pregnancy, Hepatitis, etc.), a diagnosis should be in order.
The latest research points to the fact that ICP is hereditary and can skip several generations. Although it will not help your present situation, it would not hurt to ask family members (especially Grandmothers, Mothers, Aunts) if they ever itched, had stillbirths, or experienced any of the other possible symptoms during pregnancies.
It is important that a woman suffering from this disease make sure her doctor is educated regarding the treatment and risks involved. ICP is very rare, and many midwives, doctors, and other medical staff are not informed about the proper procedures for handling this type of disease. Don’t be afraid to print out articles on the internet, call other doctors, e-mail other ladies, or do anything to help get the medical attention that is needed.