Itchy During Pregnancy

Itching is common during pregnancy. It is commonly thought to be caused by high levels of certain chemicals in the blood, such as hormones. Later, as your bump gets bigger, the skin on your belly gets stretched and this can also be itchy.Mild itching is common during pregnancy due to increased blood supply to the skin. As your pregnancy progresses and your baby grows, the skin on your abdomen stretches and this can also be itchy. Mild itching is usually nothing to worry about, but if the itching becomes severe, it may be a sign of a serious liver condition called obstetric cholestasis. It affects less than 1 in 100 pregnant women, but requires medical attention.

Mild itching

• Wearing loose clothes can help prevent itching because clothes are less likely to rub against skin and cause irritation. 
• You can also choose natural fabrics like cotton that allow air to circulate close to your skin and avoid synthetic materials. 
• You may find that taking a cool short bath or applying lotion or moisturizer can help soothe the itching.
• Some women find that products with strong fragrances can irritate their skin, so you can try using lotion or soap.

Severe itching: obstetric cholestasis

• If you are worried about itching or if you have severe itching, it is important to consult your doctor.

Obstetric cholestasis 

• Obstetric cholestasis , also called intrahepatic cholestasis of pregnancy, is a serious liver condition that affects a small number of pregnant women, usually during the last 3 months of pregnancy.

Causes of obstetric cholestasis

• The cause of Obstetric cholestasis  is unclear, but it is thought that increased pregnancy hormones later in pregnancy may slow the normal flow of bile - the digestive fluid made in the liver that helps your digestive system break down fats. In CO, bile salts accumulate rather than leave the liver, and eventually enter the bloodstream, which can cause itching.
• Obstetric cholestasis  seems to run in families, although it can occur without a family history. It is also more common in women of Indian and Pakistani descent. If you had CO in a previous pregnancy, you are more likely to develop it again in a subsequent pregnancy.
• Babies of women with CO are more likely to be born prematurely or stillborn, or to have lung problems from breathing in meconium. Because of these complications, your doctor may consider inducing labor earlier than expected.

Symptoms of obstetric cholestasis

• The classic symptom of Obstetric cholestasis  is itching without a rash, usually on the palms and soles of the feet, but it can be more widespread. 
• The itching may be relentless or unbearable, and worsen at night.

• Other symptoms include dark urine, jaundice (yellowing of the skin and whites of the eyes), and pale stools (poo).
• The itching usually disappears a few days after delivery.

Treatment of obstetric cholestasis

• Obstetric cholestasis  is diagnosed by taking a medical and family history and blood tests that check your liver function (liver function tests - LFTs). Once Obstetric cholestasis  is diagnosed, you will have regular LFTs until your baby is born, so your doctor can monitor your condition.
• Creams, such as calamine lotion, are safe to use during pregnancy and can relieve itching. Your doctor may prescribe medication to reduce bile salts and relieve itching.
• Obstetric cholestasis  can affect your absorption of vitamin K, which is important for healthy blood clotting. You may therefore be offered a vitamin K supplement.
• If you are diagnosed with Obstetric cholestasis , your midwife and doctor will discuss your condition and your options with you.