Obstetric cholestasis

Despite its ubiquity during pregnancy, itchy skin needs to be checked by your GP or midwife because it can be a symptom of obstetric cholestasis (AKA intrahepatic cholestasis of pregnancy or ICP)

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What is cholestasis?

When the liver is functioning properly, bile salts go from your liver to your gut to help you digest food. But if this doesn't happen properly, the bile salts build up in your body. During pregnancy, this is known as obstetric cholestasis or ICP, and it may increase the risk of foetal distress and premature birth. 

Who gets ICP?

Obstetric cholestasis appears to run in families, although women who have no known family history can still develop it. 

If you've had it in a previous pregnancy, it's more likely to develop again in any subsequent pregnancy. It's also more common in Asian women of Indian and Pakistani origin. However, it can happen to anyone, which is why it's especially important that all pregnant women be aware of the condition and its symptoms.

itchy feet

What are the symptoms?

Many women experience itching in pregnancy - but the feeling of ICP can be incredibly intense, or simply a persistent, irritating minor itch. Some women don't have any rash, while others get a severe rash.

It is often the palms of your hands and soles of your feet where it's most unbearable, sometimes spreading up your arms and legs, and the sensation can be particularly bad at night - but then again, it can occur anywhere and at any time.  

It usually occurs in the second or third trimester and is diagnosed by blood tests that check your liver function. It's very important to report any itching to your GP or midwife, and to get tested if there's any concern. 

Treatment for ICP

You can get creams, antihistamines and/or steroids to help manage the itching, and medication may be prescribed after diagnosis, to reduce bile sorts. However, there's no absolute cure for ICP - except having your baby. After delivery, mercifully the condition should disappear. 

If there are concerns for your baby's health, you could be induced early, from 37 weeks, and it may be advised that you give birth in hospital, where you can be monitored by the necessary medical staff.

What Mumsnetters say about cholestasis

  • "I had ICP that developed in my 31st week and had to be very closely monitored (daily hospital visits in the end). It can be serious if left undetected but with medical monitoring things should be fine. I had my baby five weeks early in the end because things started to get worse, so it was safer to get him out. From personal experience, I cannot stress enough the importance of getting any itching checked out."
  • "The only cure for cholestasis is to have your baby. My itching stopped the same day I had my son."
  • "I have just delivered a healthy baby girl after being diagnosed with obstetric cholestasis at 37 weeks. There are two tests: liver function and bile acids. The bile test is the important one - your other liver functions can be normal when the bile is raised, so getting the bile one done is important."

Resources: ICP Support is a charity dedicated to helping women with the condition, their partners, midwives, and anyone else affected.

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Last updated: 3 months ago