Cholestasis gravidarum: a liver disease that is risky for the baby

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Philippe Gloaguen
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Cholestasis pregnant

La cholestasis of pregnancy is a rare complication that occurs during pregnancy, most frequently in the third trimester, and is caused by the presence of bile (a natural chemical) in the blood circulation. We talk about cholestasis when hepatocytes (liver cells) do not do their job well and let bile acids pass into the blood instead of dumping them into the bile. The latter accumulate in the blood and risk reaching the fetus via the placenta.





In this article

  • The causes of cholestasis gravidarum
  • Symptoms
  • Pregnancy cholestasis: the risks for the fetus and the mother
  • Cholestasis of pregnancy: the cure

The causes of cholestasis gravidarum

The exact cause of cholestasis gravidarum it is not known, although some researchers suggest it may be a reaction to the hormonal change that occurs during pregnancy. The disease can have familiarity, in fact, a history of cholestasis in the family or in a previous pregnancy, could affect risk factors. Finally, some ethnic groups are more at risk, while others are virtually protected.



Symptoms

La cholestasis of pregnancy it is manifested by severe generalized itching, which worsens at night and may involve the palms of the hands and soles of the feet. Itching can lead to scratching injuries, and difficulty sleeping.



Il liver function tests (transaminases, bile acids) is then used to confirm the diagnosis and evaluate the degree of cholestasis and the increase or rise in transaminases, gammaGT, cholic acids and sometimes even bilirubin.

Read also: Complications in late pregnancy

Pregnancy cholestasis: the risks for the fetus and the mother

Apart from the discomfort caused by itching, cholestasis gravidarum is rarely a concern for the mother, while the risks of cholestasis gravidarum are mainly borne by the fetus, because theaccumulation of bile salts in the blood it can be toxic and could result in stillbirth. In other cases, preterm birth may occur.

Cholestasis of pregnancy: the cure

Obstetric cholestasis therapy involves the use of emollients and antihistamine drugs (e.g. chlorphenamine) to reduce maternal itching.

The use ofursodeoxycholic acid: represents the most used drug, its function is to protect liver cells and promote the elimination of excess bile salts. There Vitamin K in water-soluble formulation it should be administered to all women with obstetric cholestasis, especially in the case of steatorrhea (fatty stools). The latter is related to factors area of coagulation, therefore its administration reduces the risk of postpartum haemorrhage and neonatal haemorrhages.

In any case, our advice is to consult your doctor.

After giving birth, the itching gradually disappears and the liver returns to its normal activity. But in a subsequent pregnancy, the mother will be monitored closely to avoid any risk of relapse.

curated by Elisa Santaniello

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