Obstetric cholestasis

Obstetric cholestasis (sometimes called "cholestasis of pregnancy", "OC", "intrahepatic cholestasis of pregnancy", "ICP") affects the liver, which in some women seems to be oversensitive to pregnancy hormones. Bile is produced in the liver and normally it flows down the bile ducts into the intestines where it helps with the digestion of food. If you have OC, the flow of bile into the intestines is reduced and so bile salts build up in your blood.

The main symptom is itching, which is usually worse at night so can result in fatigue and insomnia. It often begins on the palms of the hands and the soles of feet and can become generalised. Some women are made so desperate by the itching that they scratch themselves until their skin is bleeding. Less commonly, women can develop jaundice. The itching completely disappears within a couple of weeks of giving birth.

The condition poses an increased risk of harm to the baby and needs to be recognised promptly. Mothers with OC may be at risk of bleeding after the birth. This is because bile is needed to absorb vitamin K from food, and vitamin K helps the blood to clot. So in some hospitals the mother is given vitamin K daily by mouth until delivery to protect her from this small risk of bleeding. The baby is also protected by the vitamin K.

As far as the baby is concerned, the principal aim of treatment is to eliminate the risk of stillbirth by delivering him as soon as his lungs are mature enough for him to survive outside the womb. Scans will be used to monitor his growth and wellbeing. At present, doctors think it best to deliver the baby at about 35 to 38 weeks. If women with OC have their labours induced at this time, their babies are very likely to survive, while if pregnancy is allowed to continue to 40 weeks, the risk of stillbirth increases.
Future pregnancies should also be monitored closely as obstetric cholestasis usually increases in intensity in subsequent pregnancies.

Delay in diagnosis, misdiagnosis and the delay in birth or inadequate treatment can all lead to devastating consequences for mother and baby. Our team are experienced with birth related cases and understand that it can be difficult to recall exactly what happened in the confusion and trauma or the birth process.

If you think you may have a case for compensation contact us and seek specialist advice from one of our clinical negligence lawyers. You can either fill out our online enquiry form, request a call back or call us direct on 0800 915 4650.