A mom's warning about itching when pregnant: "Don't ignore it!" – All you need to know about ICP


Don't ignore the itch – a mother's story

In 2017, Christine DePino's Facebook complaining may just have saved her baby's life.

The now mother of a beautiful baby girl, Lexa Rae, posted on Facebook, "If you're pregnant and you're itching REALLY bad, don't ignore it!"

Christine told TODAY, "What had started as an all-over itch started to become more pronounced on the palms of my hands and the soles of my feet. It got to the point that I could no longer sleep at night... my arms and legs were bleeding from all the scratching."

But after posting about it on Facebook, her friends urged her to check it out. Her doctor diagnosed her with intrahepatic cholestasis of pregnancy and recommended they induced labour at 37 weeks to lower the health risks to her unborn child.

Christine explains in her post that what was "basically harmless" to her, except for the awful itch of course, "could have caused a still born after 37 weeks".

But she concludes, after giving birth to her gorgeous girl, "We are so blessed! Thanks guys for giving some amazing advice which may have just saved our precious girl's life! Now I will be the crazy lady running around telling all the preggie ladies to beware!"

Read the full post here:

So while it can be normal to itch during pregnancy due to changes in hormones and skin stretching, the itching can also be a symptom of intrahepatic cholestasis of pregnancy (ICP).

What is ICP?

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder of pregnancy that affects around 5 000 women each year in the UK alone; at present this figure is unknown in South Africa.

What are the symptoms of cholestasis?

  • Itching (also called pruritus):
  • Although itching typically starts from around 28 weeks it can present as early as the first trimester and may be mild or so severe that you scratch your skin until it bleeds.
  • The itch usually affects the hands and feet, but may occur anywhere on your body.
  • Many women find that it is worse at night and it disturbs their sleep.
  • There is no rash associated with the itch, but there may be marks on your skin from scratching.

Other symptoms:

  • Some (but not all) women with ICP develop other symptoms. These may include dark urine, pale stools and, less commonly, jaundice (yellowing of the skin and whites of the eyes).
  • Some women with ICP may feel generally unwell, tired and lose their appetite.

What are the risks?

There is a risk of spontaneous preterm labour, fetal distress and in severe cases, stillbirth. However, with careful management the risk of stillbirth in an ICP pregnancy is believed to be the same as that of a normal pregnancy (1%).

What are the causes?

The cause of ICP is not fully understood but is likely multifactorial: researchers have found hormonal, genetic and environmental links.

How is ICP diagnosed?

To make a diagnosis of ICP, other liver conditions need to be ruled out first with either blood tests or liver ultrasound scanning.

  • Bile acid test: A bile acid test is believed to be the most specific test for ICP. Bile acids are thought to be harmful because they may be responsible for some of the complications that could affect your baby. In South Africa, bile acid may be ordered by special request.
  • Liver function test: This blood test looks at how well the liver is working. With ICP, special attention is paid to your ALT levels, although these are not always raised.

How is ICP treated?

The most effective treatment is still to be established but typically includes prescribing the medication UDCA (ursodeoxycholic acid), monitoring bile acid levels closely with weekly blood tests, and delivering the baby around 36–38 weeks.

What happens once my baby is born?

Around 6-12 weeks after you have your baby your liver function should be checked to confirm that it's normal as sometimes there may be an underlying liver condition that is not ICP and has caused the itching and abnormal liver readings during your pregnancy.

Will I get ICP again?

In a subsequent pregnancy there is a 90% chance of you developing ICP again.

More information and support visit www.icpsupport.org.

Remember to always consult a medical professional with your medical concerns during pregnancy.

Read more:

Have you had any problems during your pregnancy? Share your stories with us by emailing chatback@parent24.com and we may publish your comments, anonymously if you'd like.

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