Cholestasis of pregnancy is a unique complication in the middle and late stages of pregnancy. Cholestasis of pregnancy has an effect on a small section of pregnant women. Itchy skin without skin lesions often appears in the third trimester, sometimes with mild jaundice, few other symptoms.
In terms of indicators, it caused mild and moderate elevation of transaminase and bilirubin and elevation of glycolic acid and in some pregnant women experienced postpartum hemorrhage. However, cholestasis of pregnancy has a greater impact on the fetus, which can cause fetal distress, sudden unpredictable fetal death in the third trimester, Neonatal intracranial hemorrhage, neonatal nervous system problems, etc.(1)
Lifestyle Changes For Cholestasis Of Pregnancy
Although no studies have currently been conducted on cholestasis of pregnancy and nutrition, there is evidence that women who experience cholestasis of pregnancy may follow a healthy eating plan. The American Liver Foundation endorses a healthy diet that makes the liver work easier and aids to heal liver damage. Women suffering from pregnant cholestasis show some symptoms of itching getting reduced following a nutritious diet that includes real foods that are fresh, whole, and unprocessed.
The Argentina Perinatal Research Group for the Clinical Practice Guide suggests a healthy diet as part of therapy. Remember that there is no preventive or treatment option and once diagnosed, you cannot reverse cholestasis of pregnancy by opting for a healthy diet and lifestyle changes.
A healthy diet should not alter treatment or a treatment plan that the care provider has implemented, such as the drug ursodeoxycholic acid (UDCA or Urso), and early delivery after 37 weeks. A good diet and lifestyle are important factors for your health and maintaining a healthy lifestyle and eating a healthy diet during pregnancy are even more important.(3) (4)
Home Remedies And Other Alternative Treatment Options For Cholestasis Of Pregnancy
Home remedies often fail to deliver major relief from the symptoms of pregnancy cholestasis. However, you can always try some home remedies to relieve your symptoms, particularly itching. These include cold and oatmeal bath or use of herbal soothing creams on the itchy skin (however, look for cream allergies before selecting the cream or lotion).
Evidence of effective alternative treatments to combat pregnancy cholestasis is lacking. So, it is better to stick to the conventional treatment plan.
Always remember to follow medical advice and lifestyle changes and home remedies can only give you relief from symptoms when followed along with the medicines or treatment protocol recommended by your doctor.(4)
Common Treatment Plan For Cholestasis Of Pregnancy
Nowadays, most of the drugs used in the treatment of cholestasis of pregnancy are mainly symptomatic. Commonly used medicines include phenobarbital, dexamethasone, S-adenosylmethionine, and ursodeoxycholic acid.
But the treatment effect is not satisfactory, and some drugs pose a certain threat to the safety of mothers and children for patients with poor compliance. The pathogenesis of cholestasis of pregnancy from the perspective of kidney-reproduction, spleen-transportation, and liver-relief should be the goal. However, for most individuals, the drugs can significantly improve the symptoms; reduce serum bile acid levels and the incidence of fetal complications.(4)
Etiology Of Pregnancy Cholestasis
The normal level of bile in your system cannot enter the intestine. When this happens, it can be due to various reasons, such as changes in the liver cell membrane, tight junction changes, etc. Pathological changes vary with time and etiology. The macroscopic view of the liver often enlarges, the color turns green, and the swelling is obvious at the edges. Nodules may appear in further development. The clinical manifestations are mainly jaundice, pruritus, dark urine, and pale stools that are characteristic of cholestasis.(2)
Differential Diagnosis: The symptoms of pruritus and impaired liver function with elevated serum aminotransferase and bile acid levels are the two basic conditions for the diagnosis of cholestasis of pregnancy; in addition, there are jaundice, diarrhea, yellow urine, and pain in the liver area.
Examinations: Prenatal examinations routinely ask for skin sputum, and carefully check for skin scratches. At the same time, your doctor will pay attention to the atypical manifestations of early cholestasis of pregnancy, such as elevated liver enzymes, jaundice symptoms, diarrhea, yellow urine, and pain in the liver area, so as to promptly discover cholestasis of pregnancy.
- Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy. Obstetrics & Gynecology. 2014;124(1):120-133.
- Webb GJ, Elsharkawy AM, Hirschfield GM. The etiology of intrahepatic cholestasis of pregnancy: towards solving a monkey puzzle. Nature Publishing Group; 2014.
- Gregory DS, Wu V, Tuladhar P, Wu V. The Pregnant Patient: Managing Common Acute Medical Problems. American family physician. 2018;98(9).
- Ovadia C, Williamson C. Intrahepatic cholestasis of pregnancy: Recent advances. Clinics in dermatology. 2016;34(3):327-334.