Cholestasis

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Diagnosis

A doctor diagnoses cholestasis of pregnancy with a physical examination and blood tests. These tests tell the doctor how the liver is functioning. They also measure the level of bile acids in the blood. Tests confirm the diagnosis when total bile acids measure 10 micromoles per liter and above.

To diagnose cholestasis of pregnancy, your pregnancy care provider will:


Ask questions about your symptoms and medical history

Perform a physical exam

Order blood tests to check how well your liver is working and measure the level of bile salts in your blood

Treatment

The goals of treatment for cholestasis of pregnancy are to ease itching and prevent complications in your baby.


Ease itching

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


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.

Soaking itchy areas in cool or lukewarm water.

It's best to talk to your pregnancy care provider before you start any medications for treating itching.


Monitoring your baby's health

Cholestasis of pregnancy can potentially cause complications to your pregnancy. Your pregnancy care provider may recommend close monitoring of your baby while you're pregnant.


Monitoring and treatment may include:


Nonstress testing. During a nonstress test, your pregnancy care provider will check your baby's heart rate, and how much his or her heart rate increases with activity.

Fetal biophysical profile (BPP). This series of tests helps monitor your baby's well-being. It provides information about your baby's movement, muscle tone, breathing and amount of amniotic fluid. While the results of a nonstress test or BPP can be reassuring, they can't really predict the risk of preterm birth or other complications associated with cholestasis of pregnancy.

Early induction of labor. Even if the prenatal tests appear normal, your pregnancy care provider may suggest inducing labor before your due date, given the risk of stillbirth.