Cholestasis is a somewhat rare condition of pregnancy. The most common symptom is itchy skin. It is a disease of the liver that usually goes away soon after delivery. I personally was diagnosed with this awful, unknown condition and it was up to that point the scariest time of my life.

Cholestasis affects only 1 in .32% of all pregnancies and is usually more common in women of Swedish or Hispanic descent. In most cases if your mother or sister had it during their pregnancies, you have a 90% chance of developing the condition also.

Cholestasis is caused by pregnancy hormones affecting the gallbladder function, causing slowing or stopping the flow of bile. The normal function of the gallbladder is to hold bile that is produced in the liver, which is necessary to breakdown fats during the digestion process. When the bile flow is stopped or slowed down, there becomes a build up of bile acids in the liver which then can spill into the bloodstream. Elevated amounts of bile acid in the bloodstream cause the itchy skin which is the most common symptom of Cholestasis.

Bile acids in the bloodstream are also dangerous to the fetus. Cholestasis is known to increase the risks for fetal distress, preterm birth, or stillbirth. As a baby is developing ,it relies on the mother’s liver to remove bile acids from the blood. This condition, therefore causes stress on the baby’s liver. Women diagnosed with cholestasis should be monitored very closely by their OB or a Perinatologist. The monitoring should include blood tests to check bile levels, and fetal heart monitoring 2-3 times weekly. In most cases, it is vital to the health of the baby to induce labor once the baby’s lungs have reached maturity to avoid the risks of stillbirth or damage to the baby’s liver. Most doctors agree that cholestasis patients are better off delivering at about 36 weeks.

There are medications that are safe to take during pregnancy that help with the itching and the overall problems associated with the condition Vitamin K is also helpful as well as specific steroids taken late in the pregnancy to help develop the baby’s lungs in preparation for the early delivery.

Recurring Cholestasis in subsequent pregnancies is likely, and in most circumstances more severe each time. Those affected should consult with their OB about the safety to themselves or the unborn child before considering another pregnancy.

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