Obstetric Cholestasis During Pregnancy: Everything You Need To Know

Obstetric cholestasis is also sometimes called intrahepatic cholestasis of pregnancy (ICP). In the United States, approximately seven out of every thousand pregnant women are affected by this liver disorder annually. The cause of the disorder is currently unknown, but it usually occurs during the last trimester, though it can occur before that time.

What is Obstetric Cholestasis?

The liver is responsible for making the dark green to yellow fluid called bile. When a pregnant woman has a reduction in the bile ducts in the liver, it is called cholestasis. The bile salts leak into the bloodstream and can cause several symptoms.

How to Test for Obstetric Cholestasis

Blood tests can assess bile acids, liver function, and bilirubin. A full medical history and physical examination should help diagnose the problem.

Symptoms of Cholestasis

One of the worst symptoms is the relentless itching, especially on the feet and hands. In some cases, it can also cause jaundice (yellowing of the whites of the eyes and skin), which tends to affect 20% of the women suffering from ICP.

Mild depression, fatigue, loss of appetite, pale or light-colored bowel movements, and dark urine are also possible issues. However, you may suffer from nausea, severe depression, or pain the upper-right quadrant.

Are all mothers at Risk? The risk is increased with mothers who have a history of liver damage or have a family member such as a sister or mother who had Cholestasis. If the mother is carrying multiple children, it can also increase the risk factors. Since the complications can exist, many doctors consider inducing labor after the 37th week or somewhere close to then.

How Will it Affect the Pregnancy?

The mother will need to be monitored closely because it is possible for the baby to be preterm or become distressed. A stillbirth is also a danger because the baby also relies on a mother's functional liver to remove the acids from the blood. Therefore, it can also be stressful to the unborn baby's liver.

Meconium is a substance in the baby's intestines that could get into the supply of amniotic fluid. Meconium is usually held in the infant's bowel until after birth. If the delivery staff or doctor notice stained amniotic fluid, the baby is probably in distress. If this is inhaled during delivery, it could cause breathing issues.


The severe itching can be remedied with Ursodiol, which reduces the bile level in the mother. It can also help reduce any complications in the unborn baby. Lukewarm water soaks can also relieve the itchy spots and sometimes icing an affected area might bring some relief. Don't take antihistamines or use corticosteroid cream because you could harm the baby, and it most likely won't help.

These are some of the most common symptoms and treatments available for the pregnant mother and baby. It is essential to discuss your history with your physician to ensure all of the possible facts are available for correctly diagnosing the obstetric cholestasis issue.

For more information, contact Naples OBGYN or a similar location.