What is intrahepatic cholestasis?
Intrahepatic cholestasis is a liver issue. Essentially, ICP disrupts the normal flow of bile acids from your liver to your gallbladder. Bile acids are crucial for digestion. When they build up in your bloodstream, they can cause uncomfortable symptoms, and if they get high enough, they can cause serious issues for pregnancy.
What causes intrahepatic cholestasis?
We don’t know what causes intrahepatic cholestasis. It may be due to the effects of progesterone, which we know slows bodily processes such as digestion. There is a correlation between low levels of Vitamin D and intrahepatic cholestasis but we don’t know that it is a cause. Having a family history of ICP increases the likelihood of ICP occurring in pregnancy, so perhaps there is a genetic component.
How common is intrahepatic cholestasis?
Intrahepatic cholestasis occurs in approximately 1% of all pregnancies, so it is pretty rare. Once you have ICP in pregnancy, there is a 90% chance it will happen again in future pregnancies.
When does it occur in pregnancy?
Intrahepatic cholestasis usually occurs in the third trimester of pregnancy, although sometimes, it can occur in the second trimester.
What are the symptoms?
The most common symptom of ICP is intense itching, particularly on the palms of your hands and the soles of your feet. This itching can range from mild to severe and often worsens at night.
Why is intrahepatic cholestasis a concern?
While the itching is uncomfortable for the mother, the main concern with ICP is the potential risk to the baby. High levels of bile acids can increase the risk of:
How is intrahepatic cholestasis diagnosed?
ICP is diagnosed by running labs to check liver function and bile acid levels in the bloodstream.
What is the treatment for intrahepatic cholestasis?
ICP can be treated with a medicine called Ursodeoxycholic Acid. This medicine helps to improve bile flow. Having regular labs to monitor bile acid levels, and watchful management is common, whether your provider is a midwife or an obstetrician. Some midwives, myself included, have a supplement protocol for clients with ICP that can be helpful in lowering bile acid levels. The only cure is for baby to be born.
Sources:
https://www.ncbi.nlm.nih.gov/books/NBK551503/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8354350/
https://pmc.ncbi.nlm.nih.gov/articles/PMC6734627/
Intrahepatic cholestasis is a liver issue. Essentially, ICP disrupts the normal flow of bile acids from your liver to your gallbladder. Bile acids are crucial for digestion. When they build up in your bloodstream, they can cause uncomfortable symptoms, and if they get high enough, they can cause serious issues for pregnancy.
What causes intrahepatic cholestasis?
We don’t know what causes intrahepatic cholestasis. It may be due to the effects of progesterone, which we know slows bodily processes such as digestion. There is a correlation between low levels of Vitamin D and intrahepatic cholestasis but we don’t know that it is a cause. Having a family history of ICP increases the likelihood of ICP occurring in pregnancy, so perhaps there is a genetic component.
How common is intrahepatic cholestasis?
Intrahepatic cholestasis occurs in approximately 1% of all pregnancies, so it is pretty rare. Once you have ICP in pregnancy, there is a 90% chance it will happen again in future pregnancies.
When does it occur in pregnancy?
Intrahepatic cholestasis usually occurs in the third trimester of pregnancy, although sometimes, it can occur in the second trimester.
What are the symptoms?
The most common symptom of ICP is intense itching, particularly on the palms of your hands and the soles of your feet. This itching can range from mild to severe and often worsens at night.
Why is intrahepatic cholestasis a concern?
While the itching is uncomfortable for the mother, the main concern with ICP is the potential risk to the baby. High levels of bile acids can increase the risk of:
- Premature birth
- Fetal distress
- Meconium aspiration syndrome (baby inhaling their first bowel movement)
- Stillbirth
How is intrahepatic cholestasis diagnosed?
ICP is diagnosed by running labs to check liver function and bile acid levels in the bloodstream.
What is the treatment for intrahepatic cholestasis?
ICP can be treated with a medicine called Ursodeoxycholic Acid. This medicine helps to improve bile flow. Having regular labs to monitor bile acid levels, and watchful management is common, whether your provider is a midwife or an obstetrician. Some midwives, myself included, have a supplement protocol for clients with ICP that can be helpful in lowering bile acid levels. The only cure is for baby to be born.
Sources:
https://www.ncbi.nlm.nih.gov/books/NBK551503/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8354350/
https://pmc.ncbi.nlm.nih.gov/articles/PMC6734627/
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