Itchy! Itchy! Itchy! Countless pregnant mothers are crazy about it! Do you know about intrahepatic cholestasis of pregnancy?

A 36-year-old pregnant woman, 36+3 weeks pregnant, came to the obstetrics department of Hunan Want Want Hospital for a consultation due to nausea, vomiting, poor appetite and body itching for 5 days. After evaluation by the obstetrician, she was considered to have intrahepatic cholestasis of pregnancy and was immediately hospitalized. After a comprehensive examination, she was diagnosed with severe intrahepatic cholestasis of pregnancy. Fortunately, the doctor diagnosed and treated her in time, and both mother and child are safe.

Popular Science Knowledge:

1. What is intrahepatic cholestasis of pregnancy?

Intrahepatic cholestasis is the most common complication during pregnancy, with the main manifestations of skin itching, jaundice, abnormally elevated serum bile acid and liver enzyme levels. It is related to genetics, environment, female sex hormone levels and immune dysfunction.

Patients with intrahepatic cholestasis have a significantly increased risk of hepatobiliary diseases, and will also significantly increase fetal intrauterine ischemia and hypoxia, amniotic fluid contamination, iatrogenic premature birth, neonatal respiratory distress and fetal perinatal mortality. It may also lead to coagulation abnormalities due to vitamin K absorption disorders in the body, increase the risk of postpartum hemorrhage and metabolic dysfunction, and seriously affect the safety of mothers and babies.

2. What are the symptoms of intrahepatic cholestasis of pregnancy?

1. Skin itching: It is the first symptom, which usually occurs between 28 and 30 weeks of pregnancy. A very small number of pregnant women also experience itching symptoms around 12 weeks of pregnancy. The itching is often persistent, mild during the day and aggravated at night. It usually starts from the palms and soles, then gradually extends to the proximal limbs and even to the face, but rarely invades the mucous membranes.

The degree of itching varies from mild to severe. Some severe itching may cause insomnia, fatigue, nausea, vomiting, loss of appetite and steatorrhea. In addition, most pregnant women will quickly disappear within a few hours or days after delivery, and a few will disappear within a week or more.

2. Jaundice: Some pregnant women develop mild jaundice within a few days to a few weeks (average 2 weeks) after the onset of itching, and sometimes only the sclera has a mild yellowing. When jaundice occurs, the color of the pregnant woman's urine becomes darker and the color of the stool becomes lighter. Jaundice generally disappears within a few days after delivery.

3. What effects does intrahepatic cholestasis of pregnancy have on mother and baby?

1. Impact on the fetus

Intrahepatic cholestasis of pregnancy mainly harms the fetus and newborn. It can cause premature rupture of membranes, fetal distress, spontaneous premature birth, or meconium staining of amniotic fluid during pregnancy. In addition, it can also lead to fetal growth restriction, intrauterine fetal death, neonatal intracranial hemorrhage, and neonatal neurological sequelae.

2. Impact on pregnant women

For the mother, long-term severe cholestasis may be complicated by vitamin K deficiency and lead to postpartum hemorrhage.

IV. Precautions for intrahepatic cholestasis of pregnancy:

1. If you experience skin itching during pregnancy, please seek medical attention promptly to check for cholestasis.

2. If diagnosed with cholestasis, follow the doctor's advice, standardize prenatal examinations, and review fetal heart rate monitoring on time. Pay close attention to fetal movements. It is recommended to download a fetal movement counting app. If the fetal movement decreases, disappears, or is frequent and restless, it is a dangerous signal of fetal intrauterine hypoxia, and you should seek medical attention immediately.

3. Eat more high-protein, high-carbohydrate, and high-vitamin foods, and less greasy, irritating, overly salty, and overly sweet foods, which are not good for the metabolism and cardiovascular function of the mother and baby.

4. Get adequate rest, mainly lying on your left side, to help increase placental blood flow and prevent premature birth.

5. Keep your skin clean and avoid using highly irritating bath detergents.

References: An Libin, Lu Hong. Obstetrics and Gynecology Nursing, 7th Edition

Hunan Medical Chat Special Author: Tang Lexin, Ward 6, Hunan Want Want Hospital Photo/Wang Rui

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(Edited by Wx)