I was 38 weeks pregnant and started with sudden itching throughout my body. Initially, for the first 2-3 days I thought it was because of dry skin and applied a lot of moisturizer, body oil but nothing seemed to help. The itching was all throughout the body. From head to toe and severe at night. I wasn’t sure if I should take it up as a serious issue and go the doctor or consider it as just another pregnancy symptom. I checked the internet and realized that this could be potentially serious issue. I went to my gyn the next day and she suspected Cholestatis and felt I should immediately go for a bile acid test. But my gyn was not even okie to wait for the results. She wanted me to deliver the baby as soon as possible. I advise every pregnant women with Itching symptom not to take it lightly. Go ahead and check with your doctor. Remember, if not tested as the right time, it could turn fatal. After all, it wouldn’t harm to be cautious than be sorry. It is definitely not worth losing your baby. So here is some low down on Obstetric Cholestatis.
Obstetric/Pregnancy Cholestatis is a rare condition in pregnancy that is usually caused in the third trimester. It affects almost less than one percent of the pregnant women. Normally bile acid which helps break down food and fat flows down into the intestines. But for some pregnant women who have Cholestatis, less bile acid flows down the intestines and the remaining build in the body.
What causes Obstetric/Pregnancy Cholestatis?
It is still unknown what causes Cholestatis. Some believe it is caused by increased stress during the second and third trimester. And some experts believe it is caused by increased level of Progesterone and Estrogen hormone in the third trimester.
What are the symptoms of Obstetric/Pregnancy Cholestatis?
While it is very common to have some itching throughout your pregnancy because of changes to your expanding skin, go to your doctor immediately if your notice the following symptoms. Note not all itching is Cholestatis
- You are in your third trimester and you have sudden itching thoughtout your body without “rashes”. Remember for some women it could even start earlier – in your second trimester
- Itching is so severe that your find it difficult to control itching. It was so hard for me that I felt I needed to use a comb with thick teeth all though my body
- Itching is more in your palms and feet and more noticeable at night. Why you have more itching at night is, because at night you are more relaxed and your notice more!
- Your itching does not ease after a day or two of using body lotion, good non-fragrant moisturizer like Aveno and a body oil like Coconut oil.
How is Obstetric/Pregnancy Cholestatis diagnosed?
Cholestatis is diagnosed by a simple blood test. Your doctor will ask you to have a blood test done for bile acid. But your itching will start earlier than it would show on your blood test results. It even takes about 2-3 days for your results to be back. It is because, it takes some time for the bile acids to build in your blood but the itching starts as soon as there is less flow of bile to your intestines. For me, the blood results came back negative the first time. The doctor felt that it would take about a week for Cholestatis to show in the blood work.
Will Obstetric/Pregnancy Cholestatis affect the baby?
This is the first question that comes to your mind. In your third trimester, you are not even worried if something affects you, all you want is to deliver your baby healthy. So to answer your question, Yes, Cholestatis affects your baby and can be even be fatal if the baby is not delivered earlier than the due date. If you have Cholestatis, you are more likely to go into premature labor at a time you are not even prepared. If you do not deliver soon enough, it can even lead to still birth. This is the reason most doctors recommend delivering the baby earlier than the due date. How earlier depends on the gestation age. Most doctors wait for 36 weeks so that the baby’s lungs are developed. If you are past 36 weeks and have recently developed itching symptoms, doctors wait for the bile acid results and the level of bile salts in results. But if you have other pregnancy complications like gestational diabetes, your doctors will prefer you to deliver as soon as possible.
When I was 38 weeks and had severe itching, I thought it was some kind of itching that would ease in a day or two. I was ignorant about this and was browsing internet one night only to find out that many women had delivered still babies because of Cholestatis.
How will Obstetric/Pregnancy Cholestatis affect you?
The itching caused by Cholestatis does not cause a rash but your will have reddish inflamed skin. You will find it very difficult to sleep at night. As for me, I was usually awake most of the night after week 38. The itching only got worser. It is also believed that some pregnant women with Cholestatis develop gestational jaundice. Some women may also bleed heavily like a mild hemorrhage.
Can Obstetric/Pregnancy Cholestatis be treated? And if yes, how?
Cholestatis cannot be treated with medications. Your doctor will only give your some advice on easing the itching and will ask you to deliver early. Your itching will go away after you have the baby in 7-10 days most of the times even earlier than that. For me, the itching lasted for about 4 days after my daughter was born.
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