Intrahepatic Cholestasis of Pregnancy is a pregnancy- related liver condition in which there are abnormalities in the flow of bile. The abnormalities in the flow of bile lead to a build up of bile acids in the mothers blood. This results in iching that can vary in type and severity. It is most common for ICP to begin in the last trimester, although it has been reported as early as a few weeks pregnant. The reason ICP is more common in the last trimester of pregnancy is because hormones are at their peak. ICP occurs in about 1 out of 1,000 pregnancies.
SYMPTOMS:
The most common symptom of ICP is itching. Itching is worst in the night in a lot of cases. It is often the ony symptom that a woman who suffers from ICP notices. It is usually more severe on the palms of the hands and soles of the feet but often the itching is all over the body.
Jaundice- Is the yellowing of skin and the whites of the eye. Although uncommon it does occasionally occur for ICP suffers.
Dark Urine- This is also a more common sign of Intrahepatic Cholestasis of Pregnancy... it could also be a sign of dehydration.
Fatigue, depression and loss of appetite are also symptoms of ICP.
Intrahepatic Cholestasis of Pregnancy can be diagnosedby two blood tests a Serum Bile Acid Test (SBA) and a Liver Function Test (LFT).
There are very serious risks that are associated with Intrahepatic Cholestasis of Pregnancy. ICP is associated with premature labor, fetal distress, hemorrhaging in both the child and mother and also STILLBIRTH.
TREATMENT:
The most important two factors in the treatment of ICP are taking a medicine Ursodeoxycholic Acid (UDCA) which reduces the bile acids in the blood stream and also delivering the baby by 36 or 37 weeks is a crucial part in the treatment for ICP.
Here is a list on the management and other treatment for ICP:
- Vitamin K for patients whose PT levels are low!
- Steroids: They are good for increasing the probability of the babys lung maturity at birth. Also, it could help some of the itching that is associated with ICP by surpressing hormone production.
The things you should observe are as Follows:
- Serum Bile Acid level is one of the most important indicators of ICP. The serum bile acid tests should be repeated at least weekly untill you deliver and again afterwards to make sure there is no underlying liver problems.
- The Liver Function Test (LFT) should be done once or twice a week as well. It's possible for an ICP patient with their Serum Bile Acid levels raised to have a normal LFT and still be at risk.
- Surveillance of your baby is very important but it cannot tottally eliminate the risk of stillbirth. You should have some or all of the techniques done twice weekly untill you deliver your baby. A biophysical profile, cardiotocography,a doppler flow study and ultrasound.
- Because ICP sufferers have a higher risk of vitamin K malabsorption, PT (clotting times) should be checked at least weekly as the delivery gets close and at the delivery to prevent maternal hemorrhage and Intra-cranial hemorrhage in the baby. It is vital for your newborn to get the vitamin K shot right after delivery.
- Early delivery as stated above is one of the most important treatments for ICP. Delivery no later than 37 weeks to prevent the risks that are associated with ICP. This goes for any case of ICP mild or severe, Bile Acids can triple in a matter of 24 hrs.
Things ICP mothers can do to help themselves:
- Drink lots of water. Water helps flush toxins out of our body.
- Lower stress levels, many woman with ICP notice that in stressful situations their itching increases.
- Lower fat intake: The less fat the less itching has been reported from ICP moms. This could be due to the fact that when you eat fats it prompts the body to secrete bile acids in the stomach to begin the digestion process which could mean more bile acids are entering the bloodstream.
- You should eliminate external irritants.
- Taking milk thistle and dandelion root are safe during pregnancy and have been proven to stregthen and benefit the liver. Before taking and herb or drug please consult your Dr.
- Sarna lotion many woman find sooting for the itching.
- It is very important that the woman that have ICP follow a diet that will help the liver during pregnancy. A low fat healthy diet is key.
If you get Intrahepatic Cholestatsis of Pregnancy it is common to develop ICP again in future pregnacys.
If you have itching during pregnancy please go get it checked out. Intrahepatic Cholestasis of Pregnancy is a very serious condition of pregnancy, while it is uncommon it still does happen. Dont risk your unborn babies life get it checked out. Itchymoms.com is the official website please check it out it is GREAT.
If you have any questions or comments please feel free to contact me at selesprincess@yahoo.com
