Facing a nagging itch during pregnancy?

It’s absolutely normal to experience some mild itching when you are pregnant as your bump grows and the skin expands and stretches. In fact, a quarter of pregnant women complain of itchy skin. But more intense and severe itching during pregnancy can be a symptom of intrahepatic cholestasis of pregnancy (ICP). It is a group of liver disorder that is specific to pregnancy and it interferes with the flow of bile.
The condition has no long term risk to a mother’s health but if left untreated, it can be dangerous for your baby. That is why you must tell your doctor if you have persistent itching.

What is intrahepatic cholestasis of pregnancy?
ICP disturbs the functioning of the liver, which results in the build-up of bile – a fluid produced in the liver to digest fats. When the blood deposits these bile acids into the tissues, itching is triggered. The condition can be uncomfortable but not life-threatening. But for the baby, the elevated levels of bile can be toxic and can cause complications if left untreated. The problems include preterm birth, foetal distress, stillbirth and meconium in the amniotic fluid.

Symptoms
Itching associated with ICP occurs in the second and third trimester of pregnancy and is severe, especially during the night. The itching can be all over the body but it’s often worse in the soles and palms.

In most cases, itching is the only one reported symptom. However, there are some lesser common symptoms associated with ICP, some of them include:

- Dark urine and pale stool
- Fatigue and nausea
- Yellowing of skin
- Loss of appetite
- Respiratory distress syndrome (failure to establish breathing)

All the symptoms usually resolve after the delivery but in some cases, it reoccurs with subsequent pregnancies.

Treatment of cholestasis of pregnancy
Here is the good news. ICP is easily treatable. In fact, the chances of stillbirth are as less as 1 per cent with active management of the condition. The typical treatment includes:

Take the prescribed medicine: Doctors might prescribe Ursodiol that helps decrease the bile acid levels in the mother’s bloodstream and relieves itchiness. The medication also protects the baby in several ways including premature ageing of the placenta, reduced risk of meconium staining, protecting baby’s heart and restoring placenta’s ability to transport the bile acid away from the baby.

Additional screening to monitor the welwellbeingeing of your bab:
The tests to monitor your baby may include blood tests. A non-stress test can detect the sign of fetal distress and biophysical profile scores to measure the volume of amniotic fluid and fetal activity.

DISCLAIMER: The views expressed in this article should not be considered as a substitute for a physician's advice. Please consult your treating physician for more details.