What Happens if I Have Cholestasis?
Intrahepatic Cholestasis of Pregnancy (ICP) is a gestational disorder of the liver that affects 1-2 pregnancies in every 1000 pregnancies. ICP is more common in South Asian women, affecting 1 in every 70 pregnancies. There may be some evidence that carrying a pregnancy with ICP may cause an increased risk for developing Type 2 diabetes or cardiovascular issues for the birthing parent. While a ICP diagnosis is serious, it is usually not life-threatening if it is managed well by your provider.
Common symptoms of ICP is severe itching of the pamls of your hands and soles of your feet. Although those are the most common places for itching with ICP, definitely let yout provider know if you have unusual itching anywhere one your body. You may also experience yellowing of the skin (jaundice), nausea, dark urine, pain in your upper abdomen, loss of appetite, and oily stools. If you have any of these symptoms, you should call your care provider immediately. Your provider will likely consider a diagnosis of ICP if you have severe itching. They will want to confirm their diagnosis by taking a sample of your blood and doing a liver blood test and a serum bile salt test.
If you are diagnosed with ICP your provider will give you ideas for treating symptoms.They suggest taking warm baths and using topical anti-itch creams. You might need to take medication to lower your bile levels. You may have a biophysical profile every week to monitor fetal health. Your provider will likely schedule an induction for you around 37 weeks of pregnancy. Having your baby a bit early may lessen the chance of complications for your baby. During labor you may need to have continuous fetal monitoring as your pregnancy will be considered high-risk with an ICP diagnosis. While ICP usually goes away after you give birth, your provider may continue to monitor your bile levels sometime in the first couple of months after your baby is born.
ICP is serious and should not be ignored. It is considered a high risk complication that can, if left untreated, can cause premature birth or even stillbirth. If you feel like you have symptoms of ICP and your provider isn’t taking it seriously, please tell your care provider that you want to move forward with the blood test. With ICP, it is always better to be safe than sorry.