Are you experiencing unbearable itching during pregnancy? This could be due to Cholestasis of Pregnancy!

Are your palms and soles itching unbearably at night during pregnancy? But when you look, there is no visible damage? This is not just an itch. In many cases, this can be a special condition related to the liver that occurs during pregnancy. We call this Cholestasis of Pregnancy. Don't worry, we will talk about everything in simple terms.

What is Cholestasis of Pregnancy?

Simply put, this is a liver condition that occurs late in pregnancy. It causes severe itching all over the body, especially on the palms and soles of the feet. Some people also call it `Intrahepatic Cholestasis of Pregnancy (ICP)`.

In this condition, your liver function temporarily decreases. As a result, the substance called bile produced by the liver begins to accumulate in the liver and blood instead of being properly excreted from the body.

Think about what this bile is. Bile is something that is made by the liver and stored in the gallbladder. When we eat food, especially fatty foods, it is this bile that helps break down those fats and digest them. It's like dish soap. So when this bile accumulates in the blood, when its level exceeds a certain level, you start to get this unbearable itching.

This condition can cause complications for both you and your baby. Therefore, if you have these symptoms, your doctor will monitor you very closely until the end of your pregnancy.

What happens if this situation occurs?

During pregnancy, your baby relies on your liver to remove waste products from his or her blood. So when your liver isn't working properly, the level of bile in your blood can increase, which can put some pressure on your baby's liver. Since the liver is the main organ that removes waste products from our body, it's not good for it to be impaired.

Is this situation common?

This is actually a fairly rare condition. It affects about one or two out of every 1,000 pregnant women. Although researchers aren't sure what causes it, it's more common during the winter months. It's also more common among some ethnic groups.

Why does this happen? What is the main reason?

The main reason is the increase in hormones in the body during pregnancy, especially estrogen and progesterone.The levels of hormones increase dramatically. Due to the effects of these hormones, the liver is unable to properly transport bile throughout the body. This means that the flow of bile is obstructed.

What happens then? Bile accumulates in the liver and starts leaking into the bloodstream. These bile salts that accumulate in the bloodstream are the main reason why your skin itches so badly.

This condition usually occurs in the third trimester of pregnancy, around 28 weeks. This is because hormone levels are at their highest during this time. Sometimes it can also be due to genetic influences. This means that if your mother or someone in your family has had this condition, you are at a higher risk of developing it too.

What are the symptoms of this condition?

The main and most obvious symptom is unbearable itching. We also call this `Pruritus` in medical terms. There are several special facts about this itching:

• The itching starts on the palms and soles of the feet.
• It can then gradually spread to other parts of the body.
• The itching is worse at night. Some people scratch so much that they can't even sleep.
• The most important thing is that you won't see any rash on the skin.

In addition to this main feature, there are other features that are rarely seen. Let's take a closer look at them.

How do you identify this exactly?

Your doctor will mainly perform a blood test to diagnose this condition.

A blood sample will be taken from you and liver function tests and serum bile acid levels will be checked.

Once the diagnosis is confirmed, your doctor will monitor your bile levels with these blood tests regularly throughout your pregnancy. Sometimes, you may also need to have an ultrasound scan to check your blood clotting ability (prothrombin time test) or to look at your liver and bile ducts.

What is the treatment and management for this?

The main medication that doctors use to treat this condition is Ursodeoxycholic acid (UDCA) . This medication helps restore your liver function and reduce the level of bile in your blood.

However, there are things you can do to manage symptoms like itching:

• Medication for itching: Ask your doctor and use the ointment or medicine he or she prescribes. Never use any medication you feel like using.
• Wear soft, loose-fitting clothing: Wear sweat-absorbing, non-tight clothing like cotton.
• Rest well: It is important to give the body rest.
• Bathing in lukewarm water: This can help reduce itching a bit as it cools the body.

In some cases, if medication is not able to control the bile levels, the doctor may decide to deliver the baby a little earlier, around 37 or 38 weeks . The reason for this is that doing so can reduce the risk of complications for the baby.

If the baby is delivered early, a steroid injection may be given to help the baby's lungs mature properly and a vitamin K supplement to prevent excessive bleeding.

What complications can occur due to this condition?

If this condition is not controlled, both mother and baby may experience some complications.

Don't be afraid of these things. These are the risks that can occur. Your doctor is aware of these risks and will take the necessary steps to prevent them. The decision to deliver the baby a little earlier is also to reduce these risks.

Is it possible to have a healthy baby with this condition?

Yes, you definitely can! Just because you have cholestasis doesn't mean your baby is unhealthy. With proper medical supervision and treatment, most mothers give birth to healthy babies.

Should someone with this condition be careful about what they eat?

There is no specific diet for this condition. However, depending on your condition, your doctor may advise you to limit certain foods. As with any pregnancy, it is important to eat a balanced diet. Aim for a diet rich in fruits, vegetables, lean meats, and protein.

Will this condition go away after childbirth?

Yes. This is the best news. This condition will completely disappear within a few days after the baby is born. Your blood bile levels will return to normal. After that, you will not need to take any medication.

But there's something to remember. You have about a 60% chance of having this condition again in your next pregnancy. If you had a more severe case this time, the chance of having it again next time can increase to 90%.

Can this be prevented? What are the risk factors?

Unfortunately, there is no way to prevent this condition from occurring. But there are some risk factors. If you have these risks, you should be a little more careful.

• If anyone in the family has had this condition.
• If this condition has occurred during a previous pregnancy.
• If you are carrying twins or triplets.
• If you have had a previous liver disease or condition such as Hepatitis C.
• If the liver is damaged.
• If you have a genetic condition that affects the production or use of bile.

When should I see the doctor?

When you are pregnant,

• If you have severe itching that won't go away, especially on the palms of your hands and soles of your feet,
• If your skin or eyes look yellow,

See your doctor immediately. Don't ignore these symptoms. Seeking medical advice as soon as possible is important for both your safety and that of your baby.