British Liver Trust

Obstetric cholestasis (OC) is a liver disorder that occurs in around one in 140 pregnancies in the UK¹. Also referred to as intrahepatic cholestasis of pregnancy (ICP), it is a condition in which the normal flow of bile out of the liver is reduced. Chemicals in the bile called bile salts (also often referred to as bile acids) can then build up and ‘leak’ into the bloodstream. This causes affected women to have increased levels of bile salts in their blood.

OC is also characterised by itching, known as pruritus. The itching generally appears in the last three months of pregnancy but can appear sooner². It is of variable severity and can be extremely distressing for the mother. Both the raised bile salts and pruritus completely disappear soon after the birth and do not appear to cause
long-term health problems for mothers. 

Several fetal complications have been reported in OC pregnancies. There is an increased risk of preterm delivery (both spontaneous and induced) and fetal distress. Some case studies have also reported stillbirth occurring near the end of pregnancy in women with OC². Therefore it is essential that the condition is recognised and treated in time.

At present, most obstetricians in the UK managing OC pregnancies deliver babies early, at around 37 or 38 weeks. This is done because it is thought that it may help prevent the possibility of stillbirth. A clinical trial is being performed in the UK with the aim of finding out whether this is the case³. 

There have been no reports of any harmful effects to babies from OC pregnancies once they have been delivered. 

What is bile? 

Bile is a yellow-green fluid produced by your liver which contains:
·         chemicals to aid digestion
·         waste products for excretion via the bowel.
Bile passes from the liver cells via small ducts to the common bile duct and on into the duodenum (part of your gut). It plays a central role in helping the body digest fat. It acts as a detergent, breaking the fat into very small droplets so that it can be absorbed from food in your gut. It also makes it possible for your body to take up the fat-soluble vitamins A, D, E and K from the food passing through the gut.