Better Me

If You’re Expecting and Your Hands and Feet Itch, It Could Be Cholestasis

When you’re pregnant and your body is changing every day, you’ll notice all kinds of unusual symptoms. Maybe you get lightheaded. Maybe food tastes different. Maybe you get nosebleeds. Talk to your doctor, but it’s likely you can manage these symptoms on your own. But if your hands and feet itch, it could be a sign of a rare complication called cholestasis.

Cholestasis is a disorder where your hormones cause the flow of bile from your liver and gallbladder to slow down or stop. The bile acids then enter the bloodstream and get deposited under your skin.

Watch for symptoms of cholestasis

“The bile acids deposit under the skin and cause intense itching,” said Heather Reed, MD, an OBGYN at Banner—University Medicine North in Tucson, AZ. “The itching is mostly on the hands and feet, but it could be your whole body that’s itching.”

You might also notice:

  • Dark urine
  • Yellow eyes and mucus membranes (jaundice)
  • Abdominal pain on your right side, near your ribs

For some women, cholestasis risk is higher

Cholestasis can happen at any time in pregnancy but it’s most common in the third trimester, Dr. Reed said. It’s rare—it only occurs in about 1 in 1,000 pregnant women. But you’re at higher risk if:

Your doctor will monitor you closely if you have cholestasis

“Cholestasis can be quite serious,” Dr. Reed said. “Bile acids are a waste product that your liver is supposed clear. If they get into the bloodstream, the baby’s liver might have to deal with them. This can cause stress to the baby that can result in preterm delivery, fetal distress, or in the worst case, a stillborn baby.”

Your doctor will probably want to do a non-stress test twice a week to monitor the baby’s heart rate for at least 20 minutes to see how the baby is doing. You should do daily kick counts (counting the number of times your baby moves) and report any changes in your symptoms or your baby’s movements to your doctor right away.

To keep your baby safe, your doctor may want to induce delivery before your due date. Liver function returns to normal soon after your baby is born.

You can try anti-itch lotions and cool baths to alleviate the itching. Medication can help, but it doesn’t treat the impaired bile flow.

“Cholestasis can be a little scary,” Dr. Reed said. “Your doctor is there to help you through this pregnancy complication.”

For more information on pregnancy and possible complications, check out:

Pregnancy Women's Health

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