Cholestasis of Pregnancy: Symptoms, Risks & Treatment
30 Mar 2025
If you’re experiencing severe itching during pregnancy—especially on your hands and feet—without a rash, you might have cholestasis of pregnancy.
Cholestasis is a liver condition that affects bile flow and can pose risks to your baby if left untreated.
The good news? With proper monitoring and treatment, most women have healthy pregnancies. Let’s explore what cholestasis is, its symptoms, risks, and how to manage it safely.
No visible rash (unlike other itchy pregnancy conditions)
Dark urine & pale-colored stool
Yellowing of the skin or eyes (jaundice, in severe cases)
Nausea, fatigue, or loss of appetite If you have intense itching, don’t ignore it—call your doctor immediately for testing!
Fetal distress (baby not getting enough oxygen)
Meconium-stained amniotic fluid (baby poops in the womb, increasing infection risk)
Stillbirth (rare but serious) Because of these risks, most doctors recommend early delivery (around 36-37 weeks) to protect the baby.
Bile acid test – Confirms if bile acids are too high (definitive test for cholestasis). Diagnosis is based on lab results + symptoms, especially severe itching.
Cold compresses – Reduce discomfort.
Moisturizing lotions (fragrance-free).
Wearing loose, cotton clothing to stay cool. Antihistamines (like Benadryl) usually don’t help because cholestasis itching isn’t caused by histamine.
Weekly bile acid tests to monitor levels. Regular checkups help determine the safest time for delivery!
Are carrying twins or multiples
Have a history of liver disease
Had cholestasis in a previous pregnancy (60-90% chance it will happen again) If you’ve had cholestasis before, talk to your doctor early in pregnancy for monitoring.
Dark urine, pale stools, or jaundice (yellow skin/eyes)
Decreased fetal movement (a sign of fetal distress) Cholestasis requires medical attention—don’t ignore itching!
Follow your doctor’s plan for early delivery.
Take ursodiol to lower bile acids. Trust your instincts and advocate for yourself—your baby’s health is worth it!
What Is Cholestasis of Pregnancy?
Cholestasis of pregnancy (also called intrahepatic cholestasis of pregnancy, or ICP) is a liver disorder that occurs when:- Bile acids (digestive fluids) build up in the liver instead of flowing into the intestines.
- These excess bile acids enter the bloodstream, causing intense itching and potential risks to the baby.
Symptoms of Cholestasis of Pregnancy
Severe itching—especially on the hands & feet (worse at night)No visible rash (unlike other itchy pregnancy conditions)
Dark urine & pale-colored stool
Yellowing of the skin or eyes (jaundice, in severe cases)
Nausea, fatigue, or loss of appetite If you have intense itching, don’t ignore it—call your doctor immediately for testing!
Is Cholestasis Dangerous for the Baby?
Yes, if left untreated, cholestasis can increase the risk of: Preterm birth (before 37 weeks)Fetal distress (baby not getting enough oxygen)
Meconium-stained amniotic fluid (baby poops in the womb, increasing infection risk)
Stillbirth (rare but serious) Because of these risks, most doctors recommend early delivery (around 36-37 weeks) to protect the baby.
How Is Cholestasis Diagnosed?
Your doctor will order: Liver function tests (LFTs) – Checks liver enzyme levels.Bile acid test – Confirms if bile acids are too high (definitive test for cholestasis). Diagnosis is based on lab results + symptoms, especially severe itching.
Treatment & Management of Cholestasis
There is no cure for cholestasis until after delivery, but treatment can help protect your baby and relieve itching.1. Medication to Lower Bile Acids
Ursodiol (Actigall) – The main medication used to reduce bile acids and protect the baby.2. Early Delivery (Induction at 36-37 Weeks)
Because cholestasis increases stillbirth risk, most doctors recommend inducing labor early (usually by 37 weeks). Waiting until 40 weeks is not advised due to rising bile acid levels.3. Anti-Itching Remedies (Safe for Pregnancy)
Oatmeal baths – Helps soothe itching.Cold compresses – Reduce discomfort.
Moisturizing lotions (fragrance-free).
Wearing loose, cotton clothing to stay cool. Antihistamines (like Benadryl) usually don’t help because cholestasis itching isn’t caused by histamine.
4. Close Monitoring Until Delivery
Frequent non-stress tests & ultrasounds to check baby’s well-being.Weekly bile acid tests to monitor levels. Regular checkups help determine the safest time for delivery!
Who Is at Higher Risk for Cholestasis?
You may have a higher risk if you: Have a family history of cholestasisAre carrying twins or multiples
Have a history of liver disease
Had cholestasis in a previous pregnancy (60-90% chance it will happen again) If you’ve had cholestasis before, talk to your doctor early in pregnancy for monitoring.
When to Call Your Doctor
Call your doctor immediately if you experience: Severe itching (especially at night) without a rashDark urine, pale stools, or jaundice (yellow skin/eyes)
Decreased fetal movement (a sign of fetal distress) Cholestasis requires medical attention—don’t ignore itching!
Final Thoughts: Cholestasis Is Serious but Manageable
Cholestasis of pregnancy can be risky for the baby, but with early diagnosis, medication, and timely delivery, most women have healthy pregnancies and babies. If you have intense itching, get tested ASAP.Follow your doctor’s plan for early delivery.
Take ursodiol to lower bile acids. Trust your instincts and advocate for yourself—your baby’s health is worth it!
