Why has itchiness come back in an obstetric cholestasis patient?

Q. Why has itchiness come back in an obstetric cholestasis patient?

Answered by
Dr. Uzma Arqam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 03, 2018 and last reviewed on: Feb 14, 2023

Hello doctor,

I was diagnosed with obstetric cholestasis two months back due to symptoms of itchy palms and feet. My LFT's and bile acids where raised. I was put on Ursodeoxycholic acid 500 mg twice daily and pregnancy vitamins. My symptoms disappeared within a week. I am closely monitored, weekly blood, growth scans, etc. But after 34 weeks, itchiness has come back. Baby is active; blood remains stable. I am not sure what to do. Should I increase my medication? Why has the itching suddenly come back after nearly three months of taking the medication? I would be grateful for your opinion.

Kindly give your opinion.



Welcome to icliniq.com.

You are right. You have symptoms and signs of OC (obstetric cholestasis) that shows itching on palms and soles in the absence of rash with abnormal LFT and bile acid and resolves after birth. Obstetric cholestasis has increased the risk of preterm birth especially iatrogenic; fetal distress causes passage of meconium that leads to cesarean section, post delivery bleeding. Due to risk mentioned above, the fetus should be monitored regularly and frequently along with mother's blood investigations to know the level of liver enzymes and bile acid.

As you are feeling increased symptoms instead of taking medications regularly, I wanted to know have you been checked for other liver-related diseases at the start of pregnancy? And when you had last CTG (cardiotocography), electronic fetal monitoring for baby. For safer side, you should have one CTG for baby's well being and repeat blood investigations for the most recent status of disease as symptoms reappear and now already you have crossed 34 weeks. Vitamin K specifically you should have for this diagnosis and baby also just after birth. Dexamethasone can be added to prescription 10 mg orally for seven days, then to stop for three days. The Ursodeoxycholic acid dose could be increased after laboratory reports. So, my advice is better to have one CTG in an emergency due to the fetal risk of still birth in OC and to repeat blood investigations for necessary changes in dose or addition of medicines I have mentioned above. I hope you understand my point. You should have laboratory tests and CTG immediately to plan further. Keep a strict check on baby's movements.

I hope this helps.

Take care.

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
I am pregnant and having severe body itching. What is the treatment?

.. raised liver enzymes. This indicates that you have a condition called obstetric cholestasis (bile acid accumulation in blood resulting in constant ithcing during third trimester of pregnancy). It needs proper treatment and you need to get LFT - live   Read full

How can itching be effectively and safely controlled during pregnancy?

.. gone through your query and reports (attachment removed to protect patient identity). Yes, it is obstetric cholestasis. During pregnancy, Udiliv (Ursodeoxycholic acid) 300 mg is the best and effective treatment for cholestasis.   Read full

What causes itching and hot feeling in between thigh and vagina?

.. as you describe mostly indicates a fungal infection. It is possible that you might be working in a hot environment or maybe sweating too much there along with wearing tight clothes. That prevents aeration of the area and promotes fungal growth.   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions.  Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this.  Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades.  Read more»

Ask your health query to a doctor online?

Ask an Obstetrician & Gynaecologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.