Yesterday I blogged about PUPPP, a pregnancy-related skin rash that causes intense itching on the skin and usually appears on the abdomen first. Another pregnancy related condition that causes intense itching is Intrahepatic Cholestasis of Pregnancy, or ICP. As I mentioned yesterday, ICP is a much more serious condition that involves the liver’s ability to secret bile. When bile backs up in the liver, bile acids in the bloodstream increase and deposit in the skin. The bile acid deposits cause extreme itching. Unlike PUPPP, ICP does not cause a skin rash. Another difference between the two conditions is where the irritation begins. With ICP, the itching usually begins on the palms and soles of the feet. Any rash that develops is a result of scratching the skin.
Another possible side effect of ICP is jaundice. ICP is the second leading cause of jaundice during pregnancy. Jaundice may cause your skin and the whites of your eyes to appear yellow. It is common in babies. Other related symptoms of ICP are fatigue, dark urine, urinary tract infections, anorexia, greasy stools, and stomach pain. In other words, there are a lot more symptoms related to ICP than PUPPP, which means you shouldn’t have to worry about ICP if you’ve got an itchy rash on your stomach and nothing else.
ICP needs to be treated right away to protect the baby, since the mother’s liver is doing all the work for both her and her baby. There are medications to help reduce bile and assist with liver function. There are also medications that can help reduce the itching. Sometimes labor is induced as soon as the baby’s lungs are developed to help protect the baby’s health, since the condition can put a lot of stress on her tiny liver. The baby also has a higher chance of releasing meconium during delivery, which can be very dangerous.
A blood test can be used to diagnose ICP. If you experience intense itching in the final trimester without a rash, consult your doctor right away.