Obstetric Cholestasis

What is Obstetric Cholestasis (OC) ?

Obstetric Cholestasis (OC) sometimes called Intrahepatic Cholestasis of Pregnancy (ICP) is a rare condition of the liver occurring in otherwise healthy women during pregnancy. For reasons that are not fully understood bile salts that are normally excreted by the liver build up in the blood and cause intense itching of the skin, particularly on the palms and soles of the feet. Symptoms are most severe during the 3rd trimester, although they sometimes occur earlier, and in many cases itching is the only symptom. Mild jaundice can also occur, but in many cases it does not, and as a degree of itching is often associated with a normal pregnancy the diagnosis of OC is sometimes missed.

Obstetric Cholestasis rarely has any long-term consequences for the mother and the itching usually disappears within a week or two of delivery, but if the condition goes undiagnosed the risk to the foetus of premature labour and stillbirth is greatly increased. A planned early delivery at between 35 and 38 weeks will generally avoid these complications, which is why a correct early diagnosis is so important.

The condition tends to increases in severity with subsequent pregnancies, making even earlier delivery of the baby necessary, and there is an increased risk of it occurring with twins.

Many of the symptoms that may be associated with OC, such as nausea and vomiting and physical and mental fatigue, are common in many normal pregnancies, but blood tests of liver function (LFT's) and bile levels (Serum Bile Acid Test) will usually lead to a definite diagnosis.

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