Intrahepatic Cholestasis

What is Intrahepatic Cholestasis?

Intrahepatic cholestasis of pregnancy is a liver disorder that occurs in pregnant women.

Cholestasis is a condition that impairs the release of a digestive fluid called bile from liver cells. As a result, bile builds up in the liver, impairing liver function.

Intrahepatic cholestasis of pregnancy usually becomes apparent in the third trimester of pregnancy. Bile flow returns to normal after delivery of the baby, and the signs and symptoms of the condition disappear. However, they can return during later pregnancies.

What are the symptoms of Intrahepatic Cholestasis?

Intense itching is the main symptom, with most women feel itchy on the palms of their hands or the soles of their feet; although some women feel itchy everywhere.

The itching is often worse at night and may be so bothersome that one can’t sleep.  The itching is most common during the third trimester of pregnancy but sometimes begins earlier. It may feel worse as due date approaches.

Once the baby is born, however, the itchiness usually goes away within a few days.  Other less common signs and symptoms of cholestasis of pregnancy may include yellowing of the skin and whites of the eyes (jaundice), nausea, and loss of appetite.

There is no rash.

What causes Intrahepatic Cholestasis?

The cause of cholestasis of pregnancy is unclear. Sometimes, the condition runs in families, with certain genetic variants having been identified. 

Pregnancy hormones also may be involved. Pregnancy hormones rise the closer you get to your due date. Doctors think this may slow the normal flow of bile — the digestive fluid made in the liver that helps the digestive system break down fats. Instead of leaving the liver, bile builds up in the organ. As a result, bile salts eventually enter the bloodstream, which can cause itchiness.

How is Intrahepatic Cholestasis diagnosed?

To diagnose cholestasis of pregnancy, doctors or medical professionals may  ask questions about symptoms and medical history, and perform a physical exam.

A blood test may be also administered to check how well your liver is working and measure the level of bile salts in the blood

What are the treatments for Intrahepatic Cholestasis?

There is currently no cure for cholestasis – but treatment aims to lessen the effects and discomfort of the itchiness. 

Where can I find out more about Intrahepatic Cholestasis?

• American Pregnancy Association
• Mayo Clinic
• NIH