How Common Is Stillbirth If You Have Cholestasis & Can Cholestasis Cause Birth Defects?

Cholestasis of pregnancy is additionally also known as intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis (OC). It is a state of the liver and as a majority, happens in the third trimester of pregnancy or late pregnancy. This condition raises an extraordinary itching on the pregnant lady’s body, particularly on feet and palms. Be that as it may, it can happen anyplace on the body. The itching is progressively obvious and serious during the night- time.(1)

How Common Is Stillbirth If You Have Cholestasis?

If cholestasis of pregnancy is not managed actively, the chances of stillbirth can reach up to 15%. However, if the condition is managed actively, including all the necessary medication and early delivery (which is usually recommended by 36 to 37 weeks), the changes can be brought down to those of an uncomplicated pregnancy (less than 1 %). It cannot be ascertained as to which pregnancies with cholestasis face the most risk and also, the mechanism of stillbirth is not yet completely understood in this condition. Thus, active management and early delivery can ensure that there is no risk of stillbirth. Hence, all pregnancies with cholestasis are recommended to be delivered early.

According to various researches conducted, there are various aspects in which cholestasis of pregnancy can lead to stillbirth. This includes premature aging of placenta, changes caused in the fetal heart due to bile acids, abnormal contraction of the vessels of the umbilical cord, etc.(2)

Can Cholestasis Cause Birth Defects?

Whether cholestasis of pregnancy can cause birth defects is still unclear and needs a lot of research, it is still evident from other studies that this condition can be a risk factor for a lot of serious conditions like meconium staining, preterm labor, preterm delivery, fetal distress, maternal hemorrhage, respiratory distress syndrome (RDS), fetal asphyxia (failure to establish breathing), stillbirth (intrauterine fetal demise), etc.(2)

Cholestasis of pregnancy may cause complications in the mother as well as the baby. In mothers, the way the body absorbs fat may get temporarily affected. This can lead to reduced levels of some factors responsible for blood clotting. However, it is a very rare scenario and liver problems are very rarely seen in the future.

The complications of cholestasis can be quite severe in babies. They may cause-

  • Preterm birth or the baby is born too early
  • Respiratory problems if there is meconium staining (that is, the baby passes stools before born)
  • During the third trimester, there may be a stillbirth (intrauterine fetal demise) if the baby is not delivered early

The complications of cholestasis of pregnancy can be very serious, especially for the baby. Hence, the doctor may decide to induce labor well before your expected date of delivery.(1)

Risk Factors For Cholestasis Of Pregnancy

A few factors may conceivably put you at an expanded danger of developing cholestasis of pregnancy. These may consist of-

  • A history, regardless of whether individual or familial, of cholestasis of pregnancy
  • A known liver condition or a background marked by liver harm
  • On the off chance that you are pregnant with twins or more(1)

Prevention Of Cholestasis Of Pregnancy

The specific reason behind this condition is not yet known though, many theories are speculated. Cholestasis of pregnancy cannot be prevented.(1)

Conclusion

Cholestasis of pregnancy can cause major complications, most of which are serious ones. Stillbirth is one such serious complication that may result due to cholestasis of pregnancy. Cholestasis of pregnancy is not known to cause any birth defects. However, there is limited research material available in that area and it needs to be explored. That said, cholestasis of pregnancy is known to cause many other complications, especially in the baby. Hence, once diagnosed it needs to be meticulously monitored and actively managed.

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