does anyone know about intrahepatic cholestasis

I'm a concern mother!  my daughter found out @ 33 weeks she had intrahepatic choleastsis of pregnancy.  they said they would induce @ 37 weeks.  I would really appreciate any input. she goes weekly for labs,strees test and u/s.

[Keith Downing, MD]

Hello,

Cholestasis of pregnancy usually occurs in the second and third trimester of pregnancy, and is characterized by itching and a rise in serum bile acid levels, and sometimes liver enzymes as well. The incidence of this disease varies by report and the cause is not very well understood.  Treatment usually consists of symptomatic relief (for the itching) and medication called Ursodeoxycholic acid or (Ursodiol) to help increases bile flow, relieve pruritus and improve liver biochemical tests.

The reason for the early, scheduled delivery is that these women are at risk for sudden intra-uterine fetal demise.  The risk increases with increased bile acid levels, however, the difficulty is that it is not predictable.  At my institution we typically conduct fetal surveillance as indicated and induce at 37 weeks.  If the bile acids are elevated we may check the fetal lung maturity at 36 weeks (by performing an amniocentesis) and plan for an induction of labor at that time if mature.  

Sounds like your daughter is getting great care.

Best regards,

Dr. Downing