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Pregnancy cholestasis: Itching jaundice during pregnancy

  1. Intrahepatic cholestasis is a liver disease that may occur during the last trimester of pregnancy. Cholestasis (bile congestion) is a condition in which the release of bile by the liver cells is obstructed. This causes bile to build up in the liver (intrahepatic), affecting liver function. Severe itching and jaundice are characteristic symptoms of this liver disease. Pregnancy cholestasis is treated with medication, although the doctor usually also recommends premature delivery. After the delivery, the complaints disappear in the mother, although complications are possible with the baby.

Causes of liver disease during pregnancy

  1. Genetic changes (mutations) in the ABCB11 or ABCB4 gene increase the risk of developing gestational cholestasis, an autosomal inherited liver disease

Symptoms of itching and jaundice

  1. Itching Pregnancy school stasis usually only presents with severe itching in the late second or early third trimester. Usually the itching starts on the palms of the hands and the soles of the feet (itchy feet)

Diagnosis and investigations

  1. A blood test

Treatment: Medication and Premature Labor

  1. Treatment of gestational cholestasis is symptomatic with ursodeoxycholic acid 15 mg / kg per day. This medication relieves the itching and reduces complications for the baby. Sometimes other drugs such as antihistamines or corticosteroids also help


  1. The prognosis is usually excellent for the mother. This is because the bile flow normalizes after the delivery of the baby, so that all signs and symptoms of the condition disappear for a few days after delivery. However, the disease carries a higher risk of fetal loss or premature delivery


  1. Some infants have a slow heart rate and a lack of oxygen during delivery (fetal distress). Recurrent cholestasis may appear in later pregnancies or with the intake of estrogen-containing oral contraceptive pills. Furthermore, women with pregnancy cholestasis are more likely to develop gallstones.

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