Question: Is delivery by 37 weeks necessary for cholestasis of pregnancy?

Given the increased risk of stillbirth in the setting of ICP, induction of labor is often recommended at 37 weeks of gestation to balance the risk of iatrogenic preterm delivery against the risk of fetal mortality.

When should you deliver with cholestasis?

You may deliver your baby early, between 37 to 38 weeks of pregnancy. This will lessen the risk to your baby. This may be by vaginal delivery with medicine to start labor.

Is delivery by 38 weeks necessary for cholestasis of pregnancy?

Should women with intrahepatic cholestasis of pregnancy be delivered early? Yes. The only known way to reduce risk of stillbirth is with early delivery. Intrahepatic cholestasis of pregnancy (ICP) is associated with an increased risk of stillbirth, and the only known way to reduce this risk is early delivery.

Do you have to be induced with cholestasis?

Preterm birth

Currently, many doctors are recommending that women who have ICP are induced at around 37–38 weeks. However, the most recent research from Ovadia et al 2019 shows that many women can now wait until 38–39 weeks of pregnancy before they need to be induced.

Can cholestasis cause birth defects?

Cholestasis may increase the risks for fetal distress, preterm birth, or stillbirth. A developing baby relies on the mother’s liver to remove bile acids from the blood; therefore, the elevated levels of maternal bile cause stress on the baby’s liver.

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What happens if cholestasis goes untreated?

Babies who get cholestasis may show signs of jaundice 3 to 6 weeks after they’re born. If your cholestasis goes untreated, you may have trouble absorbing nutrients. You may not get enough calcium and vitamin D. This can weaken your bones.

Is cholestasis of pregnancy an emergency?

However, “if the baby is in distress, an emergency C-section may be necessary,” Dr. Wider says. Cholestasis happens in just 1 to 2 in 1,000 pregnancies, but Dr. Greves says that it’s important to tell your doctor right away if you have intense itching during pregnancy, just in case.

Does cholestasis itch come and go?

Women with cholestasis may have marks from scratching themselves, but there is no actual rash. Itching goes away. Cholestasis symptoms may improve with lotions or antihistamines, but they will always come back with a vengeance. If your skin itches for a day or two and then completely resolves, that is not cholestasis.

How does cholestasis feel?

Intense itching is the main symptom of cholestasis of pregnancy. There is no rash. Most women feel itchy on the palms of their hands or the soles of their feet, but some women feel itchy everywhere. The itching is often worse at night and may be so bothersome that you can’t sleep.

How do you stop cholestasis itching?

To soothe intense itching, your pregnancy care provider may recommend:

  1. Taking a prescription drug called ursodiol (Actigall, Urso, Urso Forte), which helps to lower the level of bile in your blood. Other medications to relieve itching may also be an option.
  2. Soaking itchy areas in cool or lukewarm water.
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