What it is
ICP, intrahepatic cholestasis of pregnancy, is a liver condition where bile does not flow well. Bile acids build up in the blood and cause itching. If you have itchy palms and feet, worst at night, with no rash, this is the test to ask for. ICP affects about 1 in 100 to 1 in 300 pregnancies. It is linked to hormones and genes, not to anything you did.
What's typical
It usually starts in the third trimester. The itch is deep, on palms and soles first, then anywhere. There is no rash. Diagnosis is a bile acid blood test, which can take days to return. Above 10 confirms it; above 40 is severe. It resolves within days of birth and tends to return in later pregnancies.
What's known
ACOG and the Society for Maternal-Fetal Medicine link ICP to higher rates of stillbirth and preterm birth, rising as bile acids rise. Birth is usually planned at 36 to 37 weeks. A medicine called ursodiol is commonly used; ask your provider about it.
What helps
- Ask for a bile acid test the same day you report itching.
- Cool showers, a fan at night, and cold packs on palms and soles for short relief.
- Track the itch and the baby's movements daily. Find ICP Care online for peer support.
When to call someone
- Nowthe baby moving less than usual, any bleeding, or yellowing of your skin or eyes.
- Todayitching on your palms and soles, or itching that keeps you awake, with no rash.
- At your next visititching that is mild but new, or a prior pregnancy with ICP.
Who helps
Tools: Due Date Calculator · Birth Plan Generator
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Sources
- Society for Maternal-Fetal Medicine — Consult series on intrahepatic cholestasis of pregnancy
- ICP Care — Patient information on cholestasis of pregnancy
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