It’s pretty much a given that you’re going to be itchy at some point during pregnancy. After all, your skin is rapidly stretching to support a growing baby, and certain pregnancy-related skin conditions can crop up and cause irritation. But one new mom is warning women in a new Facebook post that extreme itchiness during pregnancy can be a sign of a serious health complication.
“If you’re pregnant & you’re itching REALLY bad, don't ignore it!!” Christina DePino writes in a Facebook post that’s gone viral. “Started having severe itching a few weeks ago, (it was keeping me up at night) thanks to a little Facebook complaining…I got the itch checked out & found out I had pregnancy cholestasis, which is basically harmless for me—except for the crazy itching—but could have caused a stillborn after 37 weeks!!” DePino says she was diagnosed in mid-March and was induced a week later. “We are so blessed,” she wrote. “Thanks guys for giving some amazing advice which may have just saved our precious girl's life!”
The Michigan woman joked that she’ll be “the crazy lady running around telling all the preggie ladies to beware” but doctors says she’s right: Cholestasis can happen to women during pregnancy, and it can be fatal for the baby.
Cholestasis of pregnancy (also known as obstetric cholestasis and intrahepatic cholestasis of pregnancy) is a condition that impairs the flow of bile (a digestive fluid) from a woman’s liver, according to the Mayo Clinic. Cholestasis usually happens during the third trimester and causes “intense itching,” usually on the hands and feet, but can also happen on other parts of your body.
Michael Cackovic, M.D., the obstetric director of the maternal cardiac disease in pregnancy program at The Ohio State University Wexner Medical Center, tells SELF that itching is the main symptom docs use to diagnose cholestatis. Other symptoms may include jaundice, nausea, and loss of appetite, according to the Mayo Clinic. Unlike other pregnancy-related itchiness, it’s not soothed by regular anti-itch medications like Benadryl. (Remember, it's important to consult your doctor before using any medication while you're pregnant.) “It’s not like it’s a little annoying—it’s bad,” he says. Christine Greves, M.D., a board-certified ob/gyn at the Winnie Palmer Hospital for Women and Babies, agrees. “It’s horrible,” she tells SELF. “The itching is relentless and gets worse at night.”
Cholestasis can cause a baby to be stillborn, as well as cause pre-term birth and fetal distress, Dr. Greves says. The risk is greatest after a woman is 37 weeks pregnant, Dr. Cackovic says. However, he adds, experts aren’t sure why that’s the case, although there is a theory that the bile acids cross the placental barrier and attack the baby’s heart.
Data on how common cholestasis is varies by geographic region, Dr. Greves says—it’s more common in Bolivia and Sweden, but also has a broad range within the United States. Dr. Cackovic's hospital does about 5,000 births a year and he says they do about one or two inductions a week due to cholestasis.
Dr. Cackovic says experts don’t know what causes the condition, but there are some theories. One is that there is a genetic component (a person is at a greater risk of developing cholestasis if a close family member also had it). It may also have a hormonal component, Dr. Greves says—estrogen seems to impact the disease and a woman’s estrogen levels are at their highest during the third trimester. If a woman is already genetically predisposed to cholestasis, the higher estrogen levels could set the condition in motion, Dr. Greves says.
Cholestasis has also been linked with other serious pregnancy-related conditions. A 12-year population-based cohort study of 1,213,668 single-baby births in Sweden published in the journal Epidemiology found that women who had gestational diabetes and preeclampsia (a potentially dangerous pregnancy complication that causes high blood pressure) were at a higher risk of also having cholestasis. However, researchers only established a correlation, not causation, so it’s hard to know if these conditions cause cholestasis or are just more likely to also occur in women with the disease.
Pregnant women who have symptoms of cholestasis are given a blood test to verify it and are put on a medication called ursodeoxycholic acid to decrease the level of bile in her blood, Dr. Greves says. “We definitely know it helps with the itching but we think it helps with the baby’s adverse outcomes too,” Dr. Cackovic says. However, he adds, that it’s typically recommended that the woman be induced before 37 weeks to lower her risk of having a stillborn.
If you’re pregnant and develop extreme itching, talk to your doctor ASAP. If it’s on the earlier side of your third trimester, you doctor may put you on medication and monitor you until you’re further along in the pregnancy to give your baby more time to develop in utero, Dr. Cackovic says. However, you shouldn’t panic if you’re given a cholestasis diagnosis. “People Google it and freak out,” he says, but with the right medication and careful monitoring, he says you and your baby should be fine.
Read DePino's original post.
This story originally appeared on Self.
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