Cholestasis of pregnancy (COP) is a condition where the liver produces too much bile during pregnancy. Bile is a waste product produced by the liver. It’s purpose is to aid digestion and absorption of fats, proteins, carbohydrates and other substances from food. When there is excess production of bile, it causes the body to produce too much cholesterol which leads to high blood cholesterol levels. Cholesterol is a fat-like substance that circulates in the blood and delivers fat to the cells. High cholesterol is known to clog arteries and cause cardiovascular disease.
COP has two types which are intrahepatic and extrahepatic.
Intrahepatic or intra-parenchymal, which means that pregnancy hormones stimulate bile ducts within the liver. This causes the liver to produce excessive amounts of bile.
Cholestatic, or extrahepatic, which means that the liver has an increased number of bile ducts.
If you have this condition, your baby is at risk for a serious liver disease. Most of the time, babies with this condition are born too early. Some of them have liver and other health problems at birth.
Besides complications at birth, the other problem that comes with this condition is high blood cholesterol which can cause a host of other problems for you and your baby.
Cholestasis of pregnancy (COP) affects about 1 in every 200 pregnancies. It is most likely to occur between 16 and 20 weeks of pregnancy.
The first step to preventing this condition is for a mom to get regular prenatal care. Let your doctor know if you notice any symptoms such as itchiness, pain or swelling in the areas around your liver. This is because regular check-ups can identify the condition early and give you the proper medical attention you need.
If your doctor thinks that you may have this condition, they may suggest a bile acid test. This is done by taking a blood sample. It can also be completed with a sample of amniotic fluid or the fluid that surrounds your baby in the uterus (cesarean delivery).
How can you treat cholestasis of pregnancy?
Your doctor may recommend that your baby be delivered by c-section if they believe that the risk is too great for the baby.
If you and your doctor decide to continue the pregnancy, they may recommend a few treatments including:
Dexamethasone (a steroid)
Intravenous immunoglobulin (IVIg)
These treatments may help with the itching and pain that is usually associated with this condition.
They may also be successful in stopping the build-up of bile acids in the blood.
While these treatments may prevent a baby from experiencing complications due to bile acids, they won’t reverse any damage that may have already been done.
The majority of women who have had these treatments go on to have healthy, normal pregnancies after their babies are born.
Most women will have a normal, healthy pregnancy and birth even if they do have this condition.
Cholestasis of pregnancy can affect any woman who is pregnant and can be a very scary experience. But by getting regular prenatal care, getting treated if necessary and by having a healthy pregnancy, you can have a successful birth and experience the joys of motherhood.
Sources & references used in this article:
- Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population‐based case‐control study (V Geenes, LC Chappell, PT Seed, PJ Steer… – …, 2014 – Wiley Online Library)
- Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome (AJ Rioseco, MB Ivankovic, A Manzur, F Hamed… – … journal of obstetrics and …, 1994 – Elsevier)
- Risk of Pregnancy Complications in Relation to Maternal Prepregnancy Body Mass Index: Population‐Based Study from F inland 2006–10 (J Metsälä, B Stach‐Lempinen, M Gissler… – Paediatric and …, 2016 – Wiley Online Library)
- Intrahepatic cholestasis of pregnancy and timing of delivery (JO Lo, BL Shaffer, AJ Allen, SE Little… – The Journal of …, 2015 – Taylor & Francis)