Why Am I So Itchy At Night During Pregnancy & When Should I Be Worried About It?

Itchiness at night is experienced by many women during pregnancy. While most of it is not a serious cause for concern, sometimes it may be related to a significant condition.(3)

Why Am I So Itchy At Night During Pregnancy?

When you are pregnant, the bloodstream to the skin is increased. Hence, it is a common phenomenon to experience itching during pregnancy. Also, itching on the abdomen might be due to the stretching of your abdomen due to increasing pregnancy. That said, very severe itching and especially during the night could be due to a more serious condition called cholestasis of pregnancy or intrahepatic cholestasis of pregnancy or obstetric cholestasis.(3)

When Should I Be Worried About Itching During Pregnancy?

You should be worried about your itching during pregnancy if you observe that the itching typically worsens during the sight, so much so that your sleep is completely disturbed. As this nightly itching could be an indication of cholestasis of pregnancy, it is necessary that you consult your care provider immediately. Cholestasis of pregnancy is a condition of the liver in which the bile flow in the body is disturbed. Bile generally travels from the liver to the digestive region to help indigestion. When there is cholestasis of pregnancy, this flow is disturbed and there is an accumulation of bile in the body, resulting in an intense itching all over the body, especially in soles and palms. The itching is usually not accompanied by any rash. Some of the other signs and symptoms caused due to cholestasis of pregnancy are grayish stools, dark urine, yellowness of the eyes and skin (jaundice)

Cholestasis of pregnancy is a potentially hazardous condition as it may result in preterm birth or stillbirth. Hence, if you experience any kind of itching during pregnancy, especially the one that worsens at night, it is advisable to consult your pregnancy care provider immediately.(1,3)

Risk factors for cholestasis of pregnancy include:

Some factors may potentially put you at an increased risk of developing cholestasis of pregnancy. These may include –

  • A history, whether personal or familial, of cholestasis of pregnancy
  • A known liver condition or a history of liver damage
  • If you are pregnant with twins or more(2)

Though there is no sure way of knowing whether you would develop cholestasis of pregnancy in your second pregnancy if you already have a history during your first one, you may still be at an elevated risk of getting this condition during your second one. It is recommended to make your doctor aware of the history of your pregnancy when you plan or consult for your second one.

Diagnosis For Cholestasis Of Pregnancy

Your healthcare provider will ask you about your medical history as well as your current symptoms. He may perform a detailed physical examination. He may also order for a blood test to assess the functioning of your liver. The blood test would also help in detecting and measuring the degree of bile salts in your blood. All these factors considered together can be helpful in establishing a correct diagnosis.(4)

Conclusion

Itchiness at night during pregnancy can be due to various reasons. Some of the reasons for this itching are trivial while others can be quite serious. One such serious reason is cholestasis of pregnancy or intrahepatic cholestasis of pregnancy (ICP). It usually occurs during the last trimester or late pregnancy and is characterized by severe itching, especially at night. Cholestasis of pregnancy can cause a number of complications in both mother and baby. One such serious complication I stillbirth. Hence, if you experience severe itching during pregnancy which especially aggravates at night, it is best to consult with your doctor to rule out or actively manage cholestasis of pregnancy.

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