Cholestasis of Pregnancy: Here's All You Need To Know

ByRohan Sharma
Updated: 13 May 2025, 10:35 pm

If you are experiencing liver-related symptoms during pregnancy, one possible cause could be cholestasis. It’s important to recognise the symptoms early and seek specialist care, as it can pose serious risks to both you and your baby.

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Cholestasis of pregnancy is a condition that can occur when there are issues with bile flow or a buildup of bile acids in the bloodstream. It often causes intense itching, particularly on the hands and feet. The condition is usually triggered by hormonal changes, genetic factors, or pre-existing liver conditions.
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It's important to understand the implications of this condition and seek expert medical advice. With the right treatment and support, you can manage cholestasis effectively and maintain a healthy pregnancy.

Causes of Cholestasis of Pregnancy

Cholestasis of pregnancy can happen due to several reasons, and understanding these can help you stay prepared and manage the condition more easily.

  • Hormonal changes

Pregnancy-related hormonal changes can influence liver function and bile synthesis. Higher oestrogen and progesterone levels can cause poor bile flow, which might lead to cholestasis.

  • Genetic factors

If you have a family history of cholestasis, your chances of developing the condition may be higher. You may also be more likely to experience problems with bile flow during pregnancy if you have certain genetic traits.

  • Liver function

Existing liver diseases, such as hepatitis or fatty liver disease, can increase the risk of cholestasis during pregnancy.

Symptoms of Cholestasis of Pregnancy

Recognising the symptoms of this disorder is crucial for timely treatment.

  • Intense itching

The most common symptom is intense itching, particularly on the palms and soles. This itching can be severe and may worsen at night, affecting sleep.

  • Dark urine

You may notice darker urine, which indicates increased bile acids in the bloodstream. This symptom can also be accompanied by pale stools.

  • Jaundice

In some cases, this condition can lead to jaundice. With this, the skin and eyes may appear yellow. This occurs due to the accumulation of bilirubin and requires immediate medical attention.

Risk Factors & Complications Due to Cholestasis of Pregnancy

Cholestasis carries several risks that can affect both you and your baby.

  • Risk factors

  • Complications

Cholestasis can lead to serious complications if untreated.
  • High bile acid levels can affect the baby’s heart rate and overall well-being.
  • Early detection and treatment are essential to reduce risks and ensure a safer pregnancy.
  • In severe cases, this condition can lead to stillbirth, which is why early delivery is often recommended to protect the baby’s health.

Diagnosis of Cholestasis of Pregnancy

It’s important to diagnose cholestasis early, as confirming the condition involves several steps.

  • Medical history

To diagnose this disorder of pregnancy, your doctor first reviews your medical history. You may discuss your symptoms, such as when the itching starts and how severe it is, as well as any past liver issues or cholestasis. This helps your doctor assess your risk and decide on further tests. Being open about your symptoms ensures an accurate diagnosis and the right treatment. This is essential because cholestasis can sometimes resemble other conditions.

  • Blood tests

Blood tests play a vital role in diagnosing cholestasis of pregnancy as these measure bile acid levels and liver function markers. Elevated bile acid levels are indicative of cholestasis, while abnormal liver function tests can signal underlying issues. Your healthcare expert may recommend fasting blood tests to ensure accurate results. Monitoring these levels throughout your pregnancy can help track changes in liver function and bile acid accumulation. Timely blood tests are essential for diagnosing cholestasis early, allowing you to opt for proactive management and intervention to minimise risks to both you and your baby.

  • Ultrasound

Diagnosing cholestasis of pregnancy relies primarily on blood tests, while ultrasound is a supportive tool used to rule out other possible causes of symptoms. Using sound waves, this non-invasive technique generates images of the growing foetus and liver. An ultrasound can help rule out other causes of your symptoms, such as liver disease or gallstones. It also allows doctors to monitor the baby's development and check for any potential problems. If cholestasis is diagnosed, regular ultrasounds may be recommended to ensure the health of both you and your baby. This imaging helps guide treatment and delivery decisions, supporting a safer pregnancy.

Treatment of Cholestasis of Pregnancy

If you are diagnosed with cholestasis, it's best to consult your doctor about treatment options to help manage it safely for you and your baby.

  • Medications

Healthcare professionals commonly prescribe medications to manage cholestasis of pregnancy effectively. Ursodeoxycholic acid is often used to lower bile acid levels and relieve itching. This drug can enhance liver function and lower cholestasis-related complications. Your particular situation and treatment response help the expert decide the suitable dose for you. Monitoring the efficacy of the medicine and making any required changes depend on regular follow-ups. Discussing any worries or side effects with your expert is vital, as it guarantees that you get the most efficient and safest therapy.

  • Monitoring

Ongoing monitoring is crucial for managing cholestasis of pregnancy. This includes regular blood tests to check liver function and bile acid levels, ensuring they remain within safe limits. Your healthcare expert may recommend appointments every few weeks, particularly in the third trimester when this disorder is most likely to develop. Monitoring helps identify any complications early and allows for timely intervention. Additionally, your expert may discuss your birthing plan, considering the risks associated with cholestasis. Maintaining open communication with your healthcare expert helps you feel supported and informed throughout your pregnancy journey.

  • Delivery Planning

Managing this disorder of pregnancy depends much on delivery planning. Your healthcare professional could advise early delivery, usually around 37 weeks, given the possible dangers of untreated cholestasis. This timing reduces the possibility of stillbirth or foetal discomfort among other issues. However, the choice between vaginal birth and cesarean section ultimately depends on individual circumstances, including the health of both the mother and the baby. You may discuss delivery plans often with your healthcare professional to guarantee your readiness and knowledge. Planning for delivery also involves talking about postnatal care since monitoring continues after the baby is born to ensure both you and your baby are safe and healthy.

Foods to Eat & Avoid if You Have Cholestasis of Pregnancy

Diet can play a significant role in cholestasis of pregnancy:

  • Foods to eat

  • Foods to avoid

Cholestasis in pregnancy requires proper awareness and management of the situation. Understanding the causes, symptoms, and complications is therefore necessary. It helps you take complete control of your health during the time of pregnancy and leads to healthy results. Always consider going for early diagnosis and appropriate treatment to reduce the risks to you and your baby. As and when you spot any symptoms, it’s best to consult with your healthcare expert.

FAQs on Cholestasis of Pregnancy: Here's All You Need To Know

  1. What are the long-term effects of cholestasis on the baby?While there are risks, such as preterm birth and foetal discomfort, most babies born to mothers with this condition are healthy. These risks can be reduced through close monitoring and timely delivery.
  2. Can cholestasis recur in future pregnancies?Certainly, if you had cholestasis in a prior pregnancy, you are more likely to get it again. Appropriate monitoring and management depend on your informing your healthcare professional of future pregnancies.
Disclaimer: Medically approved by Dr Vikas Yadav, Senior Consultant - Department of Obstetrics & Gynaecology & IVF Specialist, ShardaCare-Healthcity

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