If you’re expecting, you’re likely anticipating, or have experienced, many bodily changes.
However, sudden and intense itching during pregnancy can be a distressing and confusing experience. While some irritation is common as skin stretches, a persistent and rashless itch, particularly on the extremities, may indicate more than just dryness.
This symptom can be a sign of a liver-related condition known as intrahepatic cholestasis of pregnancy, which requires professional attention.
What is Intrahepatic Cholestasis of Pregnancy?
Intrahepatic cholestasis of pregnancy is a liver disorder that typically arises during the third trimester, occurring when the normal flow of bile is impaired.
As a result, bile acids accumulate in the liver and leak into the bloodstream rather than flowing into the digestive tract.
While the condition usually resolves shortly after delivery, it requires careful monitoring because the elevated bile levels can pose potential risks to your baby.
What Are the Symptoms to Watch For?
Intense Body Itching
Itching during pregnancy at night is a hallmark sign of this condition, especially if it’s severe enough to disrupt your sleep. The itch may occur on various parts of the body, but it usually happens on the hands and feet.
Dark Yellow Urine
Dark yellow urine during pregnancy may occur when excess bile acids are filtered and excreted by the kidneys, as they cannot flow through the gut normally.
Pale or Light-Coloured Stools
You may notice stools appearing unusually pale or clay-coloured as the bile that gives stools their typical dark pigment does not reach the digestive tract.
Jaundice
Jaundice is characterised by a visible yellow tint in the skin or the whites of the eyes. This can occur with intrahepatic cholestasis of pregnancy due to bile buildup, though it’s a less common symptom.
Nausea
Some women may experience general digestive upset or a sudden loss of appetite as impaired bile flow disrupts the body's natural ability to process fats and aid digestion.
Fatigue and Exhaustion
The combination of internal chemical imbalances and the persistent lack of sleep caused by nocturnal itching during pregnancy can lead to significant tiredness.
What Causes Intrahepatic Cholestasis of Pregnancy?
Several factors can contribute to the development of intrahepatic cholestasis of pregnancy, primarily involving how your body processes bile during the third trimester:
- Hormonal influences: Elevated levels of pregnancy hormones, such as oestrogen, can slow down gallbladder function and hinder the normal flow of bile.
- Genetic predisposition: The condition may run in families, suggesting that certain genetic markers may make some women more susceptible to liver-related sensitivities.
Treatment and Management Options
Prompt treatment is essential to lower blood bile acid levels, support a healthy environment for your baby, and reduce the likelihood of early delivery.
- Topical relief and home care: Applying aqueous cream with menthol and wearing loose, breathable clothing can provide comfort and reduce skin irritation.
- Medications for bile management: Your doctor may prescribe Ursodeoxycholic acid (UDCA) to help lower bile acid levels in the blood and ease the itch.
- Vitamin K supplements: These supplements are used to support healthy blood clotting, which can be affected by impaired bile flow.
- Regular blood monitoring: Frequent Liver Function Tests (LFTs) and bile acid measurements are vital to track the condition’s progression and ensure your safety.
- Fetal surveillance: Regular ultrasounds and cardiotocography (CTG) monitoring help your healthcare team ensure your little one is thriving.
- Planned induction of labour: In certain cases, an earlier delivery may be recommended to ensure the safest outcome for your baby.
Finding Relief and Peace of Mind
Persistent itching on the palms and feet during pregnancy is not normal and should be reported to your doctor immediately.
While getting diagnosed with intrahepatic cholestasis of pregnancy may feel daunting, proactive management can help ensure a safe journey. Therefore, staying informed and working closely with your medical team is essential to keep you and your baby healthy.
Beyond managing medical concerns, the third trimester brings unique emotional anxieties, from preparing for the newborn’s arrival to packing a hospital bag. However, prenatal classes like Flegen’s childbirth preparation class can help you process these changes in a supportive environment.
Reach out to Flegen today for expert resources and encouragement as you approach your due date!