What You Need To Know About Intrahepatic Cholestasis of Pregnancy

For obvious reasons, pregnancy affects your entire body. Many women figure out how to manage nausea, frequent urination, swollen ankles and other common symptoms of pregnancy.  Though most are simply inconveniences, there are symptoms that pregnant women need to be aware of and take action right away to be treated. For one woman, she learned why excessive itching during pregnancy is a serious symptom and how she saved her baby’s life by being treated.

In 2017, Ashley Sicher was 34 weeks pregnant and had an “invisible itch” in her hands and feet during the day. At night, the itch grew into her arms and stomach. She tried using a hairbrush to relieve the itch but to no avail. As any modern woman in today’s world would do, she searched google for an answer to her itching. Of course, the answer the internet gave her was scary, and she woke up her husband to tell them their baby was dying.

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Sicher’s internet search told her she was suffering from Intrahepatic cholestasis of pregnancy (ICP). Cholestasis is “when the bile flow in the liver itself is stopped or slowed down, this causes a build-up of bile acids in the liver which can spill into the bloodstream”. The acid in the bloodstream is what causes the itching in mom’s body and could lead to a “toxic environment” for her baby. If left untreated, ICP could cause pre-term labour or stillbirth.

Pregnancy Itch ICP
Via Simplemost.com

The couple called Sicher’s OB and they were told he would meet them at the hospital. Sicher showed her doctor the article about ICP, and though Sicher said her doctor “didn’t seem familiar with ICP”, she was admitted and testing began. They tested her liver function and bile acid levels. Her baby was monitored by performing non-stress tests to detect movement and heart-rate. A liver function test has quick results, while a bile acid level test takes 10 days to receive results. After the 10 days, it was confirmed that Sicher had ICP. Her OB said they could go home with medication to help improve the movement of bile from her liver and told her they would induce her at 37 weeks. If they waited any longer, the risk of stillbirth increased dramatically.

Only a few days later, her baby was not active during a non-stress test. Her OB tried everything to get the baby to move but was unsuccessful. Sicher was induced that day and she delivered a healthy baby girl. Other than slight jaundice, there were no significant health issues with the baby.

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Sicher believes that because they were able to diagnose the ICP properly, she was able to have a healthy baby. Unfortunately, ICP can have such subtle symptoms, it can go untreated until it’s too late. ICP can occur anytime during pregnancy, but it mostly appears during the third trimester when pregnancy hormones are at their highest. It is considered a rare complication because only 1-2 women out of 1,000 will experience ICP during pregnancy. Doctors have discovered that genetics and medical history play a big part in whether a woman will have ICP. If you have had “previous liver damage” or a family history of liver problems, you should talk with your OB or midwife about it early in your pregnancy.

Though most pregnancy symptoms are simply just annoying, it is important that you tell your OB when you experience something very out of the ordinary. Prevention and detection are your baby’s best protection against danger.

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