What is Obstetric Cholestasis?
During pregnancy, a condition of the liver happens which causes a build-up of bile in the blood stream and the liver. This condition is called as the Obstetric Cholestasis. This condition may lead to further complications in the pregnancy, however, the evidence is not yet found to prove it for certain.
The disease also causes a persistent itch in the lady; however, with the help of treatment, these itching may be relieved. Also, once the pregnancy is over, the condition also vanishes. Some times, Obstetric Cholestasis is also referred to as intrahepatic cholestasis of pregnancy.
Who gets Obstetric Cholestasis?
This condition is seen amongst one in every 100 pregnant women. Siblings and other women in the family are also at higher risk of suffering from this phenomenon during their pregnancy. Thus, pointing towards its genetic nature. Usually, women carrying twins, triplets or more are seen to be suffering from obstetric cholestasis.
Causes of Obstetric Cholestasis
The exact cause of the condition is not yet known. However, it is supposed that the hormonal and genetic factors might be the ones influencing the disease. Since during the time of pregnancy, there is an increase in the production of estrogen and progesterone hormones in the lady’s body, this might become the causatives affecting the liver, leading it to lower the rate of bile passing out along the bile ducts.
Meanwhile, genetic factors may result in the obstetric cholestasis running in the family, as it is often noticed. It is supposed that some women do suffer from the obstetric cholestasis even when they are not pregnant, but the effects are so mild that these are unnoticeable. However, at the time of delivery, the excess production of hormones, tips the balance off and results in the exaggeration of the bile problem.
Symptoms of Obstetric Cholestasis
The symptoms of obstetric cholestasis are usually observed during the third stage of the pregnancy because the hormonal levels are highest during that time. The most prominent and maybe the only chief symptom of obstetric cholestasis is the development of itch all over the body. The itch is more severe on the hands and feet and may become distressing for the lady.
It worsens as time passes by and gets cured on its own accord once the baby is delivered. Severe itching may also affect the mother’s sleep, concentration and mood. Some other symptoms to develop during the pregnancy are – tiredness, poor appetite, feeling sick and mild jaundice. However, obstetric cholestasis is not known to have any serious or long lasting effects on the mother or the baby.
Diagnosis of Obstetric Cholestasis
Usually, development of a persistent itch, which worsens over time, is the most common way to detecting the presence of obstetric cholestasis in the woman. However, in order to get a confirmed diagnosis, the doctors also perform a blood test to detect the raised levels of bile juices and liver enzymes in the blood. At times, other blood tests are also performed in order to rule out other conditions which might be causing problems in the liver, like viral hepatitis etc.
Treatment for Obstetric Cholestasis
So far, no cure has been developed for obstetric cholestasis, as it gets solved soon after the pregnancy is over itself. However, the persistent and ever increasing itching may be very distressing for the lady.
Therefore, certain measures can be taken to help ease the itching. For example, keeping cool has been observed to have an easing effect on the itching. Thus, air conditioning, taking cool showers and soaking hands and feet in ice cool water may help. Using a moisturizing cream may also be of some help.
Though not licensed to be used on pregnant women, Ursodeoxycholic acid which is naturally occurring bile acid is often used as medication in the hope that it will help in the proper functioning of the liver, thus reducing the symptoms of obstetric cholestasis. However the verdict is yet to come out on how effective the use of this medication is in the cases of obstetric cholestasis.
