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The weird itch in pregnancy: Why do your palms and soles suddenly itch?
Pregnancy is a journey full of expectations and challenges for every mother. However, during this special period, sometimes unexpected symptoms will appear suddenly. Pregnant women often experience a strange itching sensation during pregnancy, especially in the palms and soles of the feet, a phenomenon known as intrahepatic cholestasis of pregnancy (ICP). ICP is not only unbearable for pregnant women, but also may pose a potential threat to the health of mother and baby.
Globally, approximately 23% of pregnant women experience itching during pregnancy, and while most people consider it a minor annoyance caused by skin changes, this is not always the case.
Symptoms and manifestations
The main symptoms of intrahepatic cholestasis of pregnancy usually develop during the third trimester of pregnancy, but may sometimes begin as early as seven weeks of pregnancy. The most common symptoms are:
- Itching without rash, especially on the palms and soles of the feet, as well as other parts of the body.
- The itching is more noticeable at night.
- Dark urine color.
Other, less common symptoms include:
- The stool becomes lighter in color.
- Prolonged blood clotting time (possibly related to vitamin K deficiency).
- Feeling tired.
- Loss of appetite.
- Jaundice (fewer than 10% of pregnant women experience this).
While not all people with ICP experience all of these symptoms, persistent itching should be taken seriously and lead to medical evaluation.
Pathogenesis
The cause of intrahepatic cholestasis of pregnancy is not fully understood, but studies suggest that an interaction of multiple factors, including genetics, hormones, and the environment, may be involved. Estrogen levels surge during pregnancy and are thought to be one of the key factors that contribute to ICP.
The influence of hormones
In many animal studies, specific estrogens, such as estradiol 17β-D-glucosidase, are known to induce cholestasis, primarily by decreasing the uptake of bile acids in hepatocytes. In late pregnancy, increased levels of progesterone are also associated with the development of ICP, especially when secondary metabolized progesterone reaches higher levels in pregnant women.
Genetic factorsStudies have found that ICP occurs in families and that the incidence rate varies in certain regions, suggesting that this may be related to genetic factors. Specific gene mutations have been identified that may lead to problems with bile production, making some pregnant women more susceptible to the disease.
The features of intrahepatic cholestasis of pregnancy, including clustering of cases in families, point to a genetically predisposed disorder.
Diagnosis and treatment
Diagnosing ICP usually relies on blood tests, including serum bile acid tests and liver function tests. Although most pregnant women experience occasional itching, persistent itching should be reported to your obstetrician or nurse.
Many doctors treat this condition with medications, such as ursodeoxycholic acid. Although research results are inconsistent, some experts suggest that it may be beneficial for pregnant women with bile acid levels above 40 μmol/liter.
Risks if not treated promptly
If ICP is not treated promptly, it can have serious consequences for both the mother and the fetus. For example, the mother may face extreme itching, while the fetus may be at risk of premature birth, fetal distress, or even stillbirth.
Regular bile acid testing and early intervention are essential to reduce potential risks to the mother and fetus.
Conclusion
The various changes during pregnancy, especially after the third trimester, can have a range of impacts and challenges on pregnant women. Intrahepatic cholestasis of pregnancy is an example of a condition that, although common in some cases, requires adequate attention and prompt management. Faced with such a situation, can pregnant women maintain a good mental state and actively seek medical help, which is the key to reducing potential health risks?
