Obstetric cholestasis, also sometimes referred to as intrahepatic cholestasis of pregnancy, is a medical condition that specifically affects women who are pregnant. Since not a great deal was known about the condition until recent years, it was common that women were not managed properly or that they were completely misdiagnosed. This is extremely scary due to the fact that the condition can be quite serious for both the mother and her unborn baby. Even though roughly seven pregnant women out of every one thousand have this condition, it is thought that the true number is actually much higher because women still may not be properly diagnosed legal steroids provider.
Obstetric cholestasis, or intrahepatic cholestasis (also known as ICP), causes harm because it makes the liver disrupt the flow of bile through the biliary ducts. When this occurs, bile cannot be passed through the hepatic duct, which causes problems with the absorption of fats and general digestion. The condition is most commonly noticed in the third trimester when hormones are at their peaks, and is noted by jaundice and extreme itching. There are times, however, when symptoms present in the first trimester and continue throughout the duration of the pregnancy. There is a link between a family history of liver disease and ICP, which means it could be considered hereditary.
As mentioned above, ICP is most commonly noted by bouts of extreme itching. This itching can be so intense that it causes the woman to lose sleep and have daily activities impacted. The itching is most intense on the palms of the hands and the soles of the feet. While jaundice is not as common, it does indicate that the condition is much more severe. Nearly twenty percent of women diagnosed with ICP are reported to have jaundice. Other far less common symptoms include a loss of appetite, fatigue, mild depression, and dark urine.
While ICP can be quite irritating and serious for the woman, it is actually far more serious for her unborn baby. This is because fetal distress, hemorrhages, premature birth, and even still birth can all result. Roughly forty four percent of women with ICP go into labor early, giving birth before thirty seven weeks has elapsed.
The best way to treat for ICP is to diagnosis the condition early. There are a number of tests that can be ordered such as a serum bile acid test, which provide very accurate results. This test in particular requires the woman to fast so that bile acid levels in the blood can be accurately measured. When these levels are elevated, the diagnosis is usually ICP.
In earlier years, ICP was commonly treated with a medication called cholestryamine, which is a drug meant to lower cholesterol. Today, this treatment is not considered to be effective for reducing bile acid levels in the blood. Because of this, a drug called Actigall is now used as it has been shown to be more effective due to the fact that it replaces bile acids found in the blood. Actigall has also been found to reduce the risk of a woman having a still birth. Vitamin K is also commonly administered as it helps to reduce complications from bleeding and helps to improve the absorption of fat soluble vitamins. When these treatments are given before thirty two weeks gestation, steroid shots are also given to help the baby’s lung develop and to head off breathing problems in case of an early delivery. Steroids also help to control the itching the woman experiences.
It is quite important that all pregnant women be monitored on a regular basis throughout their pregnancy in order to ensure everything is progressing normally and that the baby is developing adequately. If there are any signs of fetal distress, medical intervention may be required. If the baby is more than thirty six weeks, and has mature lungs, it may be necessary to deliver in order to ease the symptoms of ICP, and protect both mom and baby.