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Dark urine and bile acids: How to identify possible warning signs of cholestasis in pregnancy?
Pregnancy is an important and anticipated moment in a woman's life. However, as the body changes, some symptoms may cause people to be highly alert. One of the less discussed but potentially dangerous conditions is intrahepatic cholestasis of pregnancy (ICP). The condition often causes severe itching and may pose health risks to the mother and fetus. This article will show you how to identify if you are at risk of cholestasis through some key signs.
What is intrahepatic cholestasis of pregnancy (ICP)?
Intrahepatic cholestasis of pregnancy, often called cholestasis of pregnancy or jaundice of pregnancy, is a medical condition in which cholestasis occurs during pregnancy. This condition usually occurs in the third trimester of pregnancy, especially when hormone levels are at their peak. Although about 23% of pregnant women experience some mild skin itching, ICP is characterized by intense itching without a rash all over the body, usually most noticeable on the palms of the hands and soles of the feet.
Signs and symptoms
Monitoring maternal signs is crucial to early detection of ICP. The following are common symptoms.
- Itching without rash, especially in the evening
- Dark urine
- Less common: light-colored stool, prolonged bleeding time, fatigue, increased nausea, decreased appetite, jaundice, etc.
- Pain on the right side of upper abdomen
Not all women with ICP experience all of the above symptoms, making early diagnosis more difficult.
Pathogenesis
The exact cause of intrahepatic cholestasis of pregnancy is not fully understood, but it is currently believed to be the result of a combination of genetic, hormonal and environmental factors. Hormone levels are at their highest during the third trimester of pregnancy, which is considered the peak period for ICP. In addition, pregnant women with twins or multiple pregnancies also show a high incidence of ICP due to their high hormonal levels.
Diagnostic methods
The diagnosis of intrahepatic cholestasis of pregnancy usually requires confirmation with blood tests, including serum bile acid testing and liver function tests. Although most pregnant women experience occasional itching, symptoms of itching without a rash or persistent and widespread itching should be reported to your obstetrician immediately. To confirm the diagnosis of ICP, doctors usually order liver function tests, although in 20% of women, liver function test results may be normal.
How to treat
Current treatments for intrahepatic cholestasis of pregnancy generally include the use of ursodeoxycholic acid. Although some studies have not shown a significant effect, this drug is still recommended for certain pregnant women with bile acid levels above 40 μmol/liter. In addition, if a pregnant woman has very significant symptoms, such as extreme itching or bile acids exceeding 100 μmol/liter, induction of labor between 34 and 39 weeks may be necessary to reduce the risk of fetal death.
Risks of untreated
If left untreated, intrahepatic cholestasis during pregnancy may lead to multiple risks for mother and fetus.
- Mothers may experience intense and painful itching, spontaneous premature labor, and other issues
- The fetus is at risk of fetal distress, aspiration of meconium, and even death
Conclusion
Intrahepatic cholestasis of pregnancy is a potentially dangerous condition, and early recognition and treatment are critical to safeguarding the health of the mother and fetus. If you or a pregnant woman you know develops symptoms that suggest ICP, you should consult a medical professional immediately to receive timely help and advice. When facing health problems, are you ready to proactively seek solutions to protect yourself and your baby's health?
