Cholestasis of pregnancy is the most common liver disease caused by pregnancy. It is characterised by itch and abnormal liver blood tests. It usually occurs late in the second trimester or early in the third trimester of pregnancy. The incidence of this disease in Australian women is thought to be 1 – 2% of all pregnancies but there is variation between different racial groups.
This condition usually presents as generalised itch which is often worse later in the day, is often made worse by heat, such as warm showers or being under blankets in bed at night and is most common on the soles of the feel and the palms of the hands. The cause of the condition is not completely known but it is thought possibly most probably to be due to oestrogen and/or progesterone hormone, as a similar condition occurs in women on the pill. There is also thought to be a family predisposition as the condition is more common in women who have had first degree relatives with the same problem.
In any pregnant woman who develops generalised itching in pregnancy it is important that a blood test to measure liver function and bile acids in the blood stream is carried out. Often an ultrasound is performed to exclude gall stones or other gall bladder and other liver conditions. The main complications of cholestasis of pregnancy resolve around an increased incidence of stillbirth. This especially occurs in women over 38 weeks’ gestation and for that reason women who have cholestasis have fetal monitoring to carefully assess the condition of the fetus and are delivered early. There is also an increased risk of spontaneous premature labour in women with cholestasis.
Dr Len Kliman is one of Melbourne’s most experienced and respected Obstetricians and Gynaecologists.
With over three decades of experience, Dr Kliman has delivered over 20,000 babies and still counting!
In 2017, Dr Kliman was awarded an order of Australia for his services to obstetrics and gynaecology.