Some pregnancy complications, such as spotting and miscarriage, are well known, but a less common condition that can be harmful to mothers and fatal for their unborn babies is often overlooked. Intrahepatic cholestasis of pregnancy is a liver condition that causes the mother's skin to severely itch and triples the risk of stillbirth.
The cause of ICP is unknown, but it is believed that pregnancy hormones affect the liver's ability to transport certain chemicals, such as bile. These chemicals build up in the blood and stimulate the nerves under the skin, which causes terrible itching.
Hilary Boyer, a mother of three, experienced ICP, and it nearly caused her to lose her son, Lucus, when he was born. He was on breathing support for about 24 hours before he was able to breathe on his own. She is now working to increase awareness about the condition.
"[I had an] overwhelming itch on my feet, and I felt like I was losing my mind — and so I did it: I dug in with my fingernails and scratched as hard as I could," Boyer told CBS. "I knew that that wasn't normal, intentionally scratching your skin off. There's a sign that there's something wrong."
Another woman, Magdalen Reese, experienced severe itching during two pregnancies. She didn't know that the itching she felt on her abdomen during her first pregnancy three years ago was ICP, and her son Henry was stillborn. When she was 32 weeks pregnant with her second child, the itching was more intense and spread over her body. She paid attention to the symptoms, went to a doctor and was treated.
"We had no proof I'd had ICP [during my first pregnancy], but it seemed too much of a coincidence," Reese says.
ICP affects one in every 1,000 pregnancies and is most common in Latina women and those of Scandinavian heritage. Signs of ICP include:
- Intense itching
- Dark-colored urine
- Light-colored bowel movements
- Yellow eyes or skin
If you experience signs of ICP, contact your doctor immediately. He or she will take blood samples to see if your liver is working properly and to measure the amount of bile salts in your blood. You may need an ultrasound to check the liver for abnormalities and to monitor your baby's well-being.
According to the Mayo Clinic, if you're diagnosed with ICP, your doctor may recommend taking a prescription medication, such as ursodiol, to relieve the itching and to decrease the absorption of bile, using anti-itch creams that contain corticosteroids or soaking your skin in lukewarm water. If your doctor does suggest corticosteroid cream, follow the instructions closely. If you use too much, you can pose an added risk to your developing baby. If the ICP is severe, your doctor will probably suggest inducing labor early.