What is the treatment for obstetric cholestasis?
There is no cure for obstetric cholestasis. As mentioned, the condition is not usually serious but can be distressing. Symptoms go once you have the baby. The following may be advised by your specialist, which may help.
Some women have found that keeping cool helps to ease the itch. Tips to do this include:
- Lowering the thermostat in your house.
- Keeping your body uncovered at night.
- Taking cool showers and baths.
- Soaking your feet or hands in iced water.
These measures may give some temporary relief, particularly before going to bed when the itch may ease enough to allow you to fall asleep. A bland moisturising cream may also give some temporary relief from itch. Some women find aqueous menthol cream helps.
This is a naturally occurring bile acid and is used as a treatment. It is often taken to help relieve itch, and usually works. It also improves the liver blood tests. However, there is little evidence that it changes the outlook for the baby. Further research is needed to be sure.
Vitamin K supplements
Vitamin K is essential for the process in your body that makes blood clot. Sometimes the level is reduced in people with liver and bile problems. So, it seems sensible to make sure that you do not lack this vitamin. This is why supplements are often advised, especially if liver enzyme and/or bile acid levels are high.
Regular antenatal checks
You may be advised to have antenatal checks more often than usual to monitor the progress of your baby carefully. You may have a blood test every week or two, to check your liver.
Will my baby be delivered early?
Until recently it was thought that there was a definite increase in the risk of stillbirth with obstetric cholestasis. Because of this, many specialists used to induce labour so that you would give birth early - usually at 37 weeks of pregnancy. However, the concern about an increased risk of stillbirth is still not clear. So your specialist should discuss the pros and cons of early delivery with you. There are sometimes risks in having your baby early too. Your specialist can advise about the most up-to-date thinking and practice on this.
Did you find this information useful?
- 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 24 6:CD000493. doi: 10.1002/14651858.CD000493.pub2.
- Lee NM, Brady CW; Liver disease in pregnancy. World J Gastroenterol. 2009 Feb 28 15(8):897-906.
- Williamson C, Geenes V; Intrahepatic cholestasis of pregnancy. Obstet Gynecol. 2014 Jul 124(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 Oct 95(40):e4949.
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