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Cholestasis of Pregnancy: Care Instructions

Overview

Cholestasis of pregnancy is a liver condition.

This condition happens when the flow of bile slows down or is blocked and doesn’t leave the liver as it normally would. Bile acids can then build up in the liver and enter the bloodstream. It may happen when hormone levels increase during pregnancy.

Cholestasis of pregnancy most often starts in the last 3 months of pregnancy. This condition may make your skin become very itchy, often on your hands and feet.

Cholestasis of pregnancy is not very common. But there are things that increase the chances of this condition, such as if:

  • You or someone in your family has had cholestasis of pregnancy before.
  • You’re carrying twins or triplets.
  • You’ve had In vitro fertilization (IVF).
  • You’ve had liver damage or hepatitis in the past.

Cholestasis of pregnancy can cause pregnancy complications. You have a higher chance of:

  • Preterm labour.
  • Having your baby early (being induced early).
  • Meconium in the fluid around your baby in the uterus.
  • Stillbirth.

Cholestasis of pregnancy goes away after you have your baby.

How is it treated?

Your healthcare provider will want to watch you and your baby more closely, usually with non-stress tests and ultrasounds. Your healthcare provider may also recommend medicines to reduce the itching. They may also ask you to take medicines to help lower the level of bile acids in your blood. To keep you both as healthy as possible, your healthcare provider may recommend an early delivery.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your healthcare provider or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Be safe with medicines. Take your medicines exactly as prescribed. Call your healthcare provider, midwife, or nurse advice line if you think you are having a problem with your medicine.
  • If your healthcare provider prescribes them, use creams or pills to help with itching.
  • Use calamine lotion on itchy areas.
  • Do not take hot showers or baths. Hot water can make itching worse.
  • After bathing, pat excess water off your skin. Then apply moisturizer before your skin dries completely.
  • Try keeping your moisturizer in the refrigerator. It may feel better on your skin.
  • Try not to scratch your skin. The more you scratch, the more itchy you may feel.
  • Watch for signs of preterm labour.
  • Follow your healthcare provider’s instructions about how often to count your baby’s movements. To keep track of your baby’s movement and information on how to count these, go to: Fetal Movement Count Chart (albertahealthservices.ca).
  • Do not use tobacco or tobacco-like products, including cannabis, and other substances. They can harm your health. They also affect your baby’s growth, health, and the development of their brain and lungs. If you need help to use less or quit, talk to your healthcare provider, or go to the Alberta Quits website.
  • Do not drink alcohol. Alcohol affects everyone differently and may be a risk to your health. Alcohol passes through the placenta to your baby and can cause problems with their growth, health, and development.
  • Pregnancy can be an emotional and unpredictable time for pregnant people. When you have complications in your pregnancy you may have more stress. This can lead to other concerns for you and your family. Talk to your healthcare provider about how you’re feeling and any concerns you have.

When should you call for help?

Call your healthcare provider, midwife, or nurse call line now or seek immediate medical care if:

  • You have other signs there may be a problem:
    • Sudden swelling of your face, hands, or feet.
    • New vision problems (such as light sensitivity, blurring, or seeing spots).
    • A severe headache.
  • Your itching gets worse or you get other symptoms.
  • You think that you are in labour or have signs of preterm labour.
  • You have vaginal bleeding.
  • You have a tickle or gush of fluid from your vagina.
  • There is a new or increasing yellow colour to your skin or the whites of your eyes.
  • You notice that your baby has stopped moving or is moving much less than normal.

Watch closely for changes in your health, and be sure to contact your healthcare provider, midwife, or nurse call line if you have any questions or concerns.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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