Ever hear of cholestasis of pregnancy?
I recently talked with Shana Strantz, a physician assistant in the OB/GYN office at Spectrum Health Gerber Memorial, about her own experiences with cholestasis.
Strantz has an interesting story that pregnant moms may want to hear about.
As a physician assistant, she sees patients for prenatal care, postpartum care, annual female exams, contraception counseling and other gynecologic matters. While she doesn’t perform deliveries, she treats patients throughout their pregnancies and in the postpartum period.
But Strantz is also a new mom herself—she gave birth to a beautiful little girl, who is now 10 months old.
Her experiences during her pregnancy were somewhat unique.
She had a great pregnancy overall and she felt fortunate to avoid any nausea or vomiting. She had the normal fatigue and aches and pains one would expect with pregnancy.
She offered to talk to me about her experiences with cholestasis.
Q: What happened toward the end of your pregnancy? What symptoms did you experience?
At about 34 weeks gestation, I started to have very mild itching of the palms and soles of my feet, which seemed to be worse in the evening. Had I not worked in obstetrics and gynecology, it may have been easy to just disregard my symptoms and think nothing of it.
Fortunately, I know about cholestasis of pregnancy. I brought up my symptoms to my obstetrician, Melissa Bayne, DO, of Spectrum Health Gerber Memorial. She ordered the necessary blood work to check for cholestasis, which are bile acids and liver enzymes.
My labs were initially normal. I continued to have symptoms, so my labs were repeated a week later. My bile acids were elevated, double normal, and my liver enzymes started to rise.
She then started me on a medication to improve my symptoms, scheduled twice weekly non-stress tests to monitor my baby and scheduled for an induction between 36 to 37 weeks gestation.
From such a normal healthy pregnancy to all this, it was quite a shocker and quite overwhelming and scary.
Of course, I was also excited—hey, I got to meet my baby earlier than expected. However, I had the extra worry about the increased risk of stillbirth and the risks of induction. I went on to have a successful induction and a healthy baby girl!
Q: What should other pregnant women watch for?
Intrahepatic cholestasis of pregnancy is a transient liver condition that develops in pregnancy with symptoms onset typically in the late second trimester and third trimester.
Symptoms include generalized itching of the skin, most commonly of the palms of the hands and soles of the feet. Symptoms tend to be worse at night.
It typically does not have a rash associated with the itching. The symptoms can be treated with a medication, although the condition can increase the risk of stillbirth. As a result, frequent fetal monitoring and early induction between 36 to 37 weeks is recommended.
If you notice these symptoms, please talk to your OB provider for further evaluation.