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Obstetric
Cholestasis - A Disease Specific To Pregnancy
by Melanie
Weltin
Intrahepatic Cholestasis
of Pregnancy or Obstetric Cholestasis is a liver disease that is
specific to pregnancy. Many times, the only symptom that occurs is
itching, particularly on the hands and feet.
The itching
disappears within a week or two of delivery and is not thought to
cause long-term problems for the mother. However, ICP does pose an
increased risk to the baby if it is not recognized and treated
properly.
The itching commonly starts in the last trimester of pregnancy, but
it can begin sooner. It can be very severe for the mother, but the
greater risk is to the unborn baby who should be delivered early,
around 35-38 weeks, to prevent the possibility of stillbirth.
Other pregnancies for the same mother may require earlier delivery
than the first baby, as the disease seems to increase in intensity
in subsequent pregnancies.
Much research on ICP is still needed to determine the exact causes
and risks of this disease. It is thought that the high levels of
estrogen produced during pregnancy cause a reduction of bile flow.
This reduction of bile flow creates a build up of bile salts in the
blood. For the mother this means itching and sometimes jaundice. For
the baby, it appears the build up of bile salts poses a danger that
becomes greater after 35-37 weeks, which can result in stillbirth.
It is essential that a woman who feels that she is itching more than
normal seeks professional help and not stops until she is properly
evaluated. This usually means having a doctor take a blood sample
for evaluation of the liver functions (LFT's). If liver functions
are abnormal and only after ruling out all other diseases and
disorders (AIDS, primary liver disease not caused by pregnancy,
Hepatitis, etc.), a diagnosis should be in order.
The latest research points to the fact that ICP is hereditary and
can skip several generations. Although it will not help your present
situation, it would not hurt to ask family members (especially
Grandmothers, Mothers, Aunts) if they ever itched, had stillbirths
or experienced any of the other possible symptoms during
pregnancies.
It is important that a woman suffering from this disease make sure
her doctor is educated regarding the treatment and risks involved.
ICP is very rare and many midwives, doctors, and other medical staff
are not informed about the proper procedures for handling this type
of disease. Don't be afraid to print out articles on the internet,
call other doctors, e-mail other ladies, or do anything to help get
the medical attention that is needed.
Article Reprinted with permission.
Visit Melanie's website at
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