Should I be concerned about the abnormal bile acid levels in my 32-week-pregnant daughter?

Hi,

Welcome to icliniq.com.

I understand your concern.

Bile acid over ten mu mol/L indicates ICP (intrahepatic cholestasis of pregnancy). But it is well documented that it is not at all associated with the risk of itching. Means no correlation of itch in intrahepatic obstetric cholestasis with bile acid.

This patient needs strict monitoring (weekly at least and as per need in addition to that if out patient) and fetal well-being (non-stress test at least twice weekly) with symptomatic relief. But mostly, this is due to pregnancy-related hormones that respond to the body, and most of the time, the patient gets relief after delivery.

But till delivery, especially in the last and third trimester require, strict monitoring of the baby as the effects on the baby silently too high can leads to premature birth, especially iatrogenic, the passage of meconium due to distress, and end up in emergency cesarean and post partum hemorrhage, stillbirth, and placental insufficiency, etc.

There is no evidence that any specific treatment improves fetal or neonatal outcomes. In addition, mothers rarely respond to ursodeoxycholic acid eight to ten mg/kg/day.

Topical emollients are safe, but efficiency is known. Colestyramine, a bile acid chelating agent, may improve pruritis in some women but may also exacerbate vitamin K deficiency, leading to the risk of postpartum bleeding and bleeding disorders in newborns. Dexamethasone should not be first-line therapy but typically have an excellent effect on the baby's lung maturity. In case of risk of premature delivery and weak growth, developmentally disabled babies, it is suggested in injection form to the mother to support the baby's lungs.

But here, cholestasis can be given orally at ten milligrams for seven days and then stopped over three days.

Cold water bath reduces itching or icing at the palms of hands and soles.

Should report if feel fewer baby movements.

Discussion with a doctor should occur regarding delivery by early intervention (around 37 weeks induction if no labor) due to the risk of perinatal morbidity.

I hope you find it helpful.

Kind regards.