What are the risks with obstetric cholestasis?
Many women with obstetric cholestasis feel very anxious about the risks of the condition to their baby. However, the vast majority of women with obstetric cholestasis have a normal healthy baby. If there is a risk, it is small; however, the concerns are as follows:
For your unborn baby
- You are more likely to give birth to your baby early (prematurely). This is usually because your obstetrician advises you that your baby should be delivered early rather than waiting for you to go into labour naturally. Obstetricians are doctors who specialise in pregnancy and childbirth. Being born too early can be risky for your baby. See separate leaflet called Premature Labour for more details.
- Obstetric cholestasis may increase your chance of having a stillbirth. The risk of a stillbirth in a normal pregnancy is about 1 in 200. The risk if you have obstetric cholestasis may be a little more than this. The evidence is still not clear and further research is being done. The risk appears to have gone down in recent years but it isn't known if this is because of better pregnancy care or as a result of obstetricians advising women to have their labour induced at around 37-38 weeks.
- There is also an increased risk of your baby passing poo (called meconium) whilst they are in the womb. This can irritate the baby's lungs if breathed in when they are being born.
There is possibly a slightly increased risk of more bleeding from the womb than is normal just after giving birth. However, again the research is not definite and there may not be any increased risk of this.
Further reading and references
Obstetric Cholestasis; Royal College of Obstetricians and Gynaecologists (May 2011)
Gurung V, Middleton P, Milan SJ, et al; Interventions for treating cholestasis in pregnancy. Cochrane Database Syst Rev. 2013 Jun 246:CD000493. doi: 10.1002/14651858.CD000493.pub2.
Lee NM, Brady CW; Liver disease in pregnancy. World J Gastroenterol. 2009 Feb 2815(8):897-906.
Williamson C, Geenes V; Intrahepatic cholestasis of pregnancy. Obstet Gynecol. 2014 Jul124(1):120-33. doi: 10.1097/AOG.0000000000000346.
Kong X, Kong Y, Zhang F, et al; Evaluating the effectiveness and safety of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy: A meta-analysis (a prisma-compliant study). Medicine (Baltimore). 2016 Oct95(40):e4949.
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