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Cholestasis: An Itch That Could Take A Life

Who knew social media could be so useful? Christina DePino was 35 weeks pregnant when she made a Facebook post about an itch that was driving her crazy. Little did she know that this itch was fatal for her baby - her friends pointed out that it could be cholestasis. When she googled this, she found that although it may not harm the mother in any way except an itch, it could cause a baby to be stillborn.

She immediately rushed over to the doctor to get herself checked. The doctors confirmed that she had intrahepatic cholestasis. The doctors advised her to have an induced birth at 37 weeks to reduce the risk of any harm to the infant. Her healthy and beautiful baby girl, Lexa Rae was born at 37 weeks and 2 days.

She is now on a mission to spread awareness about cholestasis to all those she cares about. She made the following Facebook post about it:

So what is ICP all about?

ICP (Intrahepatic Cholestasis of Pregnancy) is a group of liver disorders that affect the flow of bile during pregnancy. Normally, bile produced by the liver cells gets transported to the bile ducts using special pumps in the body. It helps with the digestion of fats.

During ICP, this bile fails to get into the bile ducts and will continue to build up in the blood. As mentioned before, ICP is a group of liver disorders which translates to dangerous amounts of bile in the blood. This can lead to the death of an unborn baby.

What are the first signs?

The first and most commonly observed symptom of cholestasis would be a case of moderate to severe itching. Other symptoms may include (but not restricted to) pale stools, nausea, fatigue, dark urine, and pre-term labour.

What causes it?

Cholestasis could be caused due to the hormonal changes in the body during pregnancy. The body produces high levels of both progesterone and estrogen which can affect the liver’s ability to transport bile. Another possible cause is the genetic factor, although it can occur even if nobody in your family has had it before. But those who have a family history of the disorder are at a higher risk than those who don’t. Environmental factors can also cause ICP - it is said to be more common in the winter months. Although they have linked selenium deficiency to cholestasis, it is not known whether it is a cause or effect.

Can it be treated or cured?

ICP can be diagnosed as early as 8 weeks and right up to the third trimester. Ursodeoxycholic Acid (UDCA) is considered safe for both mother and baby and thus can be used to treat cholestasis. Although it does reduce the risks associated with ICP, there is no cure for it except for delivery. Typically, treatment involves UDCA along with an early delivery (induced) at 36-37 weeks.

 

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