There are many reasons why you might feel itchy during your pregnancy. You might start to itch around your midsection because your skin is stretched. You also might itch because of your prenatal vitamins. The hormones released during gestation also make your skin more sensitive, so even something as simple as your perfume or fabric choices might have you scratching incessantly. However, if you’re experiencing severe, generalized itching (pruritus) all over your body (especially the soles of your feet) that won’t go away, it’s time to talk to your doctor. It could be a sign of a serious condition known as obstetric cholestasis.
Obstetric cholestasis (OC) or intrahepatic cholestasis of pregnancy is a disorder that affects the liver and develops during pregnancy. Ten percent of the affected women will develop jaundice. Essentially, it is caused by a buildup of bile salts that are supposed to be flowing to and from your liver in the digestion of food. You’re at a higher risk of OC if it runs in your family. So, if your mom had OC while she was pregnant with you, there’s a good chance you’ll get it, too. It is also more common in women in Pakistan, Sweden and Chile. Unfortunately, there is no cure for OC. Itching usually resolves within a few days of delivery, and subsequent liver problems are uncommon — although cholestasis is likely to recur with other pregnancies. Because the liver is involved and the liver is responsible for clotting factors, blood tests to check your clotting factors are done throughout the pregnancy and you may need to take Vitamin K supplements, depending on the test results. Although the condition may seem to be just a nuisance and annoying to the mother, it can lead to stillbirth. So, it is a very serious condition. Because most fetal surveillance studies, such as electronic antepartum fetal testing (nonstress test) are very poor at predicting stillbirth in this disorder, doctors recommend that women with OC with elevated bile salts need to have their labor induced at 37 weeks (after fetal lung maturity has been established) to make sure the baby makes it out healthy and happy.
If your physician determines that the cause of your itching is in fact OC, you’ll need to get regular tests to make sure your liver is functioning properly. For some women, the itching is unbearable, so you should talk with your physician if the itchiness is interfering with your daily activities. A medication, known as Actigall (ursodeoxycholic acid ) helps regulate cholesterol by reducing the rate at which the intestine absorbs cholesterol and consequently is effective in alleviating the itching. Aveeno® oatmeal baths, topical steroid creams and other steroids have been used with some success. . You should also try to scratch your skin as infrequently as possible, as open cuts from scratches could become infected. Although, when you’ve got the pregnancy itch, not scratching is obviously easier said than done!
- Yvonne S. Thornton, M. D., M. P. H.