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Signs and Symptoms of Obstetric Cholestasis

Brenda Albano

July 15, 2019

Signs and Symptoms of Obstetric Cholestasis


Often itching is the ONLY symptom noticed by a woman who suffers from ICP. The itching will increase in severity until either treatment is implemented or delivery takes place.

The itching is more pronounced on the bottoms of the hand and feet and will increase with blood flow. Although itching sounds like a minor symptom, to a woman who suffers from ICP, it can be a life-hindering problem. Loss of sleep, loss of appetite, inability to perform normal functions such as dishes, lack of ability to concentrate, and mood swings can all be attributed to itching!

Please keep in mind that some itching is normal during pregnancy. ICP itching is usually distinguished by the fact that a woman will itch over her entire body. Some women scratch themselves so frantically that they make themselves bleed.

IMPORTANT NOTE: My personal experience has been one of being “put off” by a military doctor who told me itching was normal. Demand that a blood test be run!

Dark Urine

The biochemical reactions that take place during ICP often create darker-colored urine. You might notice that after you “go potty,” the toilet looks much darker than normal. This is often a sign of dehydration, but it can point to ICP as well.


Although it is more uncommon to have jaundice in the mother, it does sometimes occur during ICP. If you notice a pale yellow appearance to the skin or eyes, please seek medical attention.

Abnormal Liver Function Testing

After the onset of ICP, a liver function test will prove to be abnormal. Things to look for that will be elevated are the AST, ALT, and Bilirubin levels (not always an indicator). These results can vary at times. They should be repeated until a diagnosis is resolved. It is common for bile salts during ICP to wax and wane, causing blood results to normalize only to become abnormal again. As soon as the itching begins, it is the best time to request a liver function test. Keep in mind that the medicines prescribed for ICP will alter the blood results.


Although fatigue is very common all throughout pregnancy, ICP can also cause fatigue through stress and loss of sleep.

Premature Labor

Another symptom of ICP is the onset of premature labor. Early delivery in mothers with ICP is encouraged, but delivering too early can be dangerous. You may wish to talk to your doctor about taking precautions such as taking a steroid shot to help the baby with developing his or her lungs.

Symptoms Not Usually Associated with ICP

A rash is not usually associated with ICP, although one may develop that is caused by all the scratching.

Also, it is not noted in any case that the disease ever gets worse after delivery. If this is the case, more testing should be done to rule out a primary liver disorder such as “normal” cholestasis. However, it may take a few weeks for the blood results to normalize and the itching to cease.

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