Midwife reveals why pregnant women should NEVER ignore itchy skin

Pregnancy causes a lot of changes to a woman’s body – some that may seem very alien.

But while these changes are fine for the most part, there are some symptoms that medical experts urge you NOT to ignore, like itchy skin!

Don’t just put it down to being another symptom of pregnancy. In fact, this midwife is urging pregnant women with this symptom to speak to their GP right away, as it could be VERY SERIOUS! 

Here’s why…

Why itchy skin is dangerous during pregnancy

Midwife Sarah posted a video to TikTok explaining that itchy skin during pregnancy could be a ver serious condition. She says if you can’t stop itching you should speak to your doctor ASAP.

“Are you pregnant and can’t stop itching? Especially your palms and your soles? You may have cholestasis of pregnancy – a liver condition that occurs in late pregnancy,” she says in the clip.

“It triggers intense itching, but without a rash.”

More about cholestasis

Like other obstetric complications, pregnancy hormones also cause your body to become itchy.

The hormones oestrogen upset the liver, slowing or stopping the flow of bile into the intestines. Bile assists the breakdown of foods after digestion and helps the body absorb nutrients.

When the liver slows, decreasing the release of bile, toxins build up in the bloodstream causing obstetric cholestasis. The livers role in our bodies is to work to detox our systems.

1% of women are affected by obstetric cholestasis, which generally occurs in the third trimester but can occur at any time.

Research suggests it is a genetic condition and generally affects mothers and sisters. Mothers who descend from Asian and South American backgrounds also have a higher incidence.

If you have had liver disease such as hepatitis, alcohol abuse or infections affecting the liver you are also at an increased risk.

If you had obstetric cholestasis in your first pregnancy it usually repeats for subsequent pregnancies.

Symptoms

• Excessive itching. Generally starting on the palms of the hands and soles of the feet. It’s itchiness under the skin that does not appear as a rash or irritation to the skin. It worsens at night.
• Jaundice or yellowing of the skin and eyes can also occur. At first it may seem like you’re a little tanned but if it’s winter that is not possible. Jaundice is caused by the build up of bilirubin, a pigment caused by the slowdown of bile production.
• Your urine may be darker in colour, which may not be noticeable if you are taking vitamin supplements. The build up of liver enzymes can also cause urinary tract infections.
• Stools ‘poo’ may also be darker than normal.

Diagnosis

• Blood tests will check for liver enzymes via a liver function test.
• Some doctors will also do an ultrasound of the gallbladder to check for gallstones as this can also cause a bile blockage.

If you have any of the symptoms above especially itching, speak to your doctor or midwife.

• Some itchiness of the skin is normal due to the hormonal changes so don’t think because you’re itchy you automatically have obstetric cholestasis.

Concerns

• Bilirubin can cause severe vitamin deficiencies so it is important to maintain supplements. You may also need regular blood tests to determine which ones require extra supplements.
• Having obstetric cholestasis can put you at higher risk for bleeding post having your baby. This is because of a deficiency in Vitamin K. Vitamin K assists with blood clotting.
• The baby may also have a Vitamin K deficiency. However, babies are given Vitamin K shortly after birth anyway.
• Sleeping can be difficult because the itch worsens at night so try getting some naps in during the day and sleeping with a fan on to cool the skin.
• Depending on the severity some women may find they are admitted to hospital for closer observation of both themselves and their baby.

Treatment

• Giving birth is the main cure however depending on your gestation this may not be possible just yet.
• Some doctors will prescribe steroids for the mother and give a steroid injection to help strengthen the baby’s lungs.
• Chinese herbalists have been used with good effect also.
• Ursodeoxycholic acid – a natural bile supplement that boosts liver function and helps decrease the itching. It’s completely safe for the baby.

Does it affect the baby?

Due to the decreased amount of oxygen in the mother’s blood crossing the placenta there is an increased risk on the baby.

Doctors and midwives will monitor you pregnancy more closely. Due to the stress on the baby, women with obstetric cholestasis are generally induced between 35-38 weeks depending on the severity.

Preventing a stillbirth is most important to the doctors. Frequent ultrasounds and heart rate dopplers will be performed. Babies can be jaundiced post birth and may need phototherapy in the special care nursery.

Nutrition

• Have a well balanced diet and omit fatty and fried foods.
• Any food that puts extra strain on the liver is best to be avoided.
• Drink plenty of water.
• Dandelion root tea is a natural detox but is best to have only a couple of times a week as even though it’s said to have benefits in pregnancy there isn’t a lot of research to support this.
• Eat foods that help the liver
  • Ginger
  • Dark green leafy vegetables
  • Beetroot
  • Carrots
  • Lemons
  • Garlic
  • Black walnuts
  • Milk thistle
  • Mint

Ways to manage itching

• Wearing light, loose cotton based clothing that breathes.
• Using creams that contain oatmeal or calendula (avoid oil based/ perfumed ones).
• Calamine lotion.
• Cool packs where itch is worse.