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Last Updated: Jan 10, 2023
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Cholestasis Of Pregnancy - Understanding What It Is!

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Dr. Sandhya MishraGynaecologist • 29 Years Exp.MBBS, MS -Gynaecologist, from WALL, From WALLS, From WALLS, From WALLS
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The bile is one of the most important digestive juices and helps in digestion of fat. It is produced in the liver and travels down through the biliary duct to the gallbladder, where it is temporarily stored, before being released into the stomach when food is present for digestion.

Pregnancy is one of the main reasons for cholestasis. When an expecting woman develops itching in the hands and feet during the late pregnancy stages, it is usually indicative of obstetric cholestasis. Read on to know more about the causes, symptoms and management for this condition.

Causes:
While the exact cause for this condition is not clear, it could have a strong genetic component. It usually runs in families. Another reason attributed are the pregnancy hormones. The increased amount of hormones in the later stages of pregnancy affects the gallbladder functioning. There is either reduced flow of bile or complete obstruction of the bile flow. This causes the bile to flow back into the blood stream, where it gets deposited in the tissues, leading to itching. The chances of developing cholestasis also increases if it is a twin pregnancy. It is also highly likely that if you had cholestasis during the first pregnancy, you will have it during the subsequent pregnancies.

Symptoms:
The itching of the palms of the hands and the soles of the feet is almost diagnostic. Some may even have generalized itching across all body parts. It worsens at night and may affect sleep. The itching increases as the pregnancy advances and gradually subsides after delivery. This is another indication that it may be related to the hormones. As the liver is affected, other symptoms similar to any liver disease are also possible. These include jaundice where the whites of the eyes and the mucous membranes could turn yellowish to yellowish orange. This is caused by accumulation of bile pigments in these tissues. There could also be severe nausea and loss of appetite, which are common symptoms in a liver disease.

Complications:
Itching is the most common symptom for the mother, which gradually subsides. However, if it sets in, doctors would advise for early labor as the risks for the developing baby are quite high. Though not well established, cholestasis increases the chances of preterm delivery and fetal death in late pregnancy stages. The chances of meconium getting into the amniotic fluid and blocking the baby’s breathing is also high. It is always advisable to watch out for these symptoms, and as soon as you see any change, especially the onset of itching, reach out for medical help.

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