Have you ever heard of ICP, or Intrahepatic Cholestasis of Pregnancy? What exactly is cholestasis? A lot of doctors do not know the cause or much about it, so they may prescribe Sarna lotion or even benadryl and knock it as being the normal pregnancy itchiness due to the stretching of the skin. Trust your gut; if it does not seem normal, do your research and show the doctors, as I had done myself because they had tried to tell me it was normal itchiness. Thank goodness I did research and showed them, as it saved my pregnancy.
Intrahepatic Cholestasis of Pregnancy is a condition during pregnancy, usually in the third trimester, that is a part of liver disorders which interfere with the flow of bile. Bile is a substance produced by liver cells to aid in fat digestion. During normal functions, the bile is transported into the bile duct. But during ICP, the cells are unable to transport the bile out, which leads to the bile acids building up in the blood. This is associated with an increased risk to your unborn baby.
Well, What Are The Symptoms, You Might Ask?
The symptoms of ICP are as follows:
Itching; this is the most common symptom and can range from moderate to severe. The itching due to ICP does not usually respond with the use of antihistamines. There is usually no rash, but one can develop due to scratching. The most common location for itching are the hands and feet, but can be anywhere, ranging from arms and legs, scalp or even all over.
Dark urine
pale stool
right upper quadrant pain
fatigue
mild depression
pre-term labor
nausea/lack of appetite
rarely jaundice
What Causes ICP?
The cause of ICP is a combination of factors such as
Genetics -- Research has identified several genetic mutations associated. Even when there is no familial history, it can still be genetic. Mothers, sisters and daughters of women affected are at higher risk of developing the disorder.
Hormones -- ICP is influenced by the high hormone levels of estrogen and progesterone, which also further interfere with the liver's ability to transport bile.
Environment -- ICP recurs in future pregnancies in about 60-90% of women, which indicate that environmental factors also play a role. It is not entirely understood, but research has found evidence that seasonal influences as well as improved nutrition may play a role. More women are diagnosed in winter, and selenium deficiency has also been linked to this disorder.
Well, What About Treatment?
The treatments below are what are recommended for ICP
Early delivery; There is absolutely no cure for ICP, except delivery. Active management also reduces the risks. The medicine ursodeoxycholic acid (also known as UDCA, Actigall, Ursodiol or Ursofalk) and early delivery by 36-37 weeks. If medicine is not controlling levels, earlier delivery may occur.
Medication - Ursodiol is considered the frontline treatment and has been proven the safest for mother and baby.
Do I Want To Know The Risks?
No, you probably do not want to know the risks, but it is much better to know so that you can get treatment ASAP. ICP puts affected pregnancies at higher risk of
preterm labor/delivery
fetal distress
meconium passage
respiratory distress syndrome (RDS)
Failure to establish breathing (sometimes called fetal asphyxia)
Maternal hemorrhage
Stillbirth (intrauterine fetal demise/IUFD)
When my son was born, they said he had a lot of meconium in his lungs, which is why he had to stay in the NICU. I was induced at 37 weeks, so if I had waited any longer, I would have probably lost him. I am so thankful for doing my research. At about 23 weeks, I had started to itch, and it didn't feel normal because it wouldn't stop or go away. I waited about a week, just in case it was this normal pregnancy stretching. A week passes, and I am feeling even itchier! So I call my doctor, explain what I had found and what my issues were, and they had me come in.
They ran tests and took some blood work, then sent me home and told me they would have results in a day or two. Sure enough, it came back with elevated liver enzymes, so they scheduled me to come in to see the doctor. I discussed with the doctor who put me on one type of medicine, (I cannot remember the name) but it did not work or help at all. I called the doctor back, and went in and explained what research I had found about the medication Urso, and they switched me to that. I still had itching, but it was so much easier to deal with and a lot less of it too!
Visit ICPcare.org for more information!
