Who Is At Risk For Cholestasis Of Pregnancy & Is There A Blood Test For It?

Not many ladies suffer a very serious itching in late pregnancy. The most widespread reason for this is cholestasis, a popular liver ailment that barely occurs in gestation. Itching typically arises on the limbs and stomach but can also impinge on other segments of the body.

This condition makes pregnant women extremely uncomfortable and more worrisome. Although, study shows this is a rare symptom yet there is proven evidence that this disorder is noted 1 in 150 women worldwide. Asian women, especially from India and Pakistan pose a higher risk of getting affected by this condition.

Who Is At Risk For Cholestasis Of Pregnancy?

Who Is At Risk For Cholestasis Of Pregnancy?

Cholestasis of Pregnancy is more common in winter months in Swedish and Chilean ethnic groups. The higher prevalence is observed in twin pregnancies and following in vitro fertilization treatment. Several studies have advocated that it is more prevalent in females over the age of 34 years. These studies also showed that there is an increased occurrence of gallstones in both affected females and their families.

One of the primary reasons causing this condition is hormone imbalance. When the individual is during the end of the second trimester or in the early third trimester, there is an imbalance in the pregnancy hormones which in turn affect the liver function nor slow/stop the flow of the bile. 1 to 2 pregnancies in 1,000 are affected by cholestasis.

If you have a past record of cholestasis in a previous gestation, your probabilities of getting this condition during a future gestation are considerably higher.1, 2 Following women have an increased risk of developing this condition

Women Carrying Multiples- Multiple pregnancies and women carrying multiples tend to increase the risk of pregnancy-associated complications especially cholestasis in pregnancy. This will result in many fetal complications, such as sudden intrauterine fetal demise and stillbirth.

Women Having The Previous History Of Liver Damage- When females have already existing underlying liver disease, they should seek consultation with a liver specialist if they are pregnant. ICP is typically considered by an accumulation of bile acids during the gestation period and is related to a higher risk of negative fetal consequences and fetal morbidity if the condition is overlooked.

Hereditary Or Genetic Factors- Women who develop Intrahepatic Cholestasis of Pregnancy have a genetic predisposition to the disorder. Genetic changes in the genes can increase a woman’s likelihood of developing intrahepatic cholestasis of pregnancy. According to Genetics and Rare Disease information specialists Cholestasis that occurs during pregnancy can be an inherited condition.3, 4

Is There Any Blood Test For Cholestasis Of Pregnancy?

Obstetric cholestasis can be confirmed by blood tests called Liver Function Tests (LFTs) and a fasting serum bile acid test.

Liver Functions Test- Liver function tests, as the name suggests is a liver examination test that is described as a hepatic panel (a group of blood tests) that provide evidence about the condition of a person’s liver. This test measures certain proteins, enzymes, and substances, including Albumin, a protein that the liver makes. In a nutshell, the ALT and AST tests measure enzymes that your liver releases in response to damage or disease. In the case of cholestasis of pregnancy, the blood test measures the level of the bile acids.

Normal blood test provides outcomes for typical liver function examinations include ALT 7 to 55 units/ltr. Higher bile acids may suggest infection or injury to cells in the liver. When the bile enzymes levels are higher, it tends to have an increased risk to the unborn baby.5,6

References:

  1. Cholestasis of Pregnancy: Causes, Symptoms and Treatment https://americanpregnancy.org/pregnancy-complications/cholestasis-of-pregnancy/
  2. Cholestasis of pregnancy – Symptoms and causes – Mayo Clinic https://www.mayoclinic.org/diseases-conditions/cholestasis-of-pregnancy/symptoms-causes/syc-20363257
  3. Intraheptic cholestasis of pregnancy (ICP) https://www.tommys.org/pregnancy/complications/obstetric-cholestasis
  4. Itching in pregnancy – Obstetric Cholestasis http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=438&np=462&id=3009
  5. Diagnosis of Intrahepatic Cholestasis of Pregnancy (ICP) https://icpcare.org/diagnosis/
  6. Cholestasis of pregnancy – Diagnosis and treatment – Mayo Clinic https://www.mayoclinic.org/diseases-conditions/cholestasis-of-pregnancy/diagnosis-treatment/drc-20363258

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