Intrahepatic Cholestasis (pruritus gravidarum, icterus
gravidarum) of pregnancy means the accumulation of bile in the liver. It is
also referred to as “Obstetrical Cholestasis”, that is, accumulation of bile
due to pregnancy. It occurs after the third month of pregnancy. Since it is a
pregnancy-related condition, it usually disappears shortly after birth. When
making the diagnosis, it should be ensured that there are no gallstones and
liver inflammation. The diagnosis is confirmed by ultrasonography and blood
tests. It is a disease encountered in approximately 500-1000 pregnancies.
The cause of pregnancy cholestasis has not been elucidated
yet. Estrogen and progensterone hormones (especially estrogen) are thought to play
a role in the development of the disease. The first symptom is itching. It
usually starts between the 7th and 8th months. First, complaints such as
nausea, vomiting, and abdominal pain may occur. No abnormality is seen on the
skin. Itching usually starts from the abdominal area and can spread to the
trunk, legs and arms, palms and soles. In more serious cases, itching may also
occur in the eyelids and in the mouth. Itching usually subsides 3-7 days after
birth. Itching generally does not respond to treatment. In mild itching, cool
bath, softening and moisturizing creams can be recommended. Jaundice may
develop in 10-15% of patients. Urine gets darker and feces turn lighter.
In the blood, bile acids (chenodeoxycholic acid, deoxycholic
acid, cholic acid), alkaline phosphotase, 5'-nucleotidase and bilirubin levels
increase. Liver transaminase enzymes (ALT, AST) can be normal or slightly high.
There is a slight or moderate increase in serum total and direct bilirubin
levels.
GIK brings some risks related to pregnancy. These include
prematurity, premature birth, contamination of amniotic water with meconium
(baby's stool), abnormal heart rate. For this reason, it is necessary to follow
strict pregnancy during the disease, monitor the fetus frequently, eliminate
discomfort in the mother and provide vitamin K support.
It generally tends to recur in later pregnancies.
-CHEMOTHERAPY AND RADIOTHERAPY IN PREGNANCY
-HEADACHE AND MIGRAINE IN PREGNANCY
-MYOMA IN PREGNANCY
-ROMATOID ARTHRITIS IN PREGNANCY
-GALLBLADDER INFLAMMATION IN PREGNANCY
-GALLSTONE IN PREGNANCY
