“My pregnancy itch was caused by a liver problem”

The unusual itch a Singaporean mum faced during her pregnancy was an ominous sign of a serious health issue…


“I’m 34 this year and have two kids. My older child, Claudia, is 2, and my baby boy, Jerome, is 4 months old.

I had obstetric cholestasis when I was pregnant with my son. It started during my 33rd week of pregnancy ― I suddenly developed a general itch at my arms, fingers, shoulders and back.

Because I have a history of dry skin and eczema, I simply attributed it to that.

However, the strange thing was that there was no rash ― and yet the itch persisted. My husband then urged me to get my gynaecologist to check it out.

Based on my symptoms, my gynaecologist suspected that it was obstetric cholestasis. When he mentioned the term, I remembered that I had developed a rash on my back towards the end of my first pregnancy, too.

During that time, I didn’t get it checked out with my gynaecologist till I delivered, but my doctor did a blood test and the diagnosis then was cholestasis, as well.

So, it seemed that history was repeating itself ― this time round, the symptoms appeared earlier, and they were definitely more obvious.

My doctor explained to us what obstetric cholestasis was. This condition, which happens in late pregnancy, is essentially a blockage in the normal flow of bile because of the way the liver works when a woman is pregnant.

When the normal flow of bile is blocked, it starts to build up, and some of it leaks into the bloodstream ― this can make the skin very itchy, which was what I experienced. The condition is rare, but can run in families.

When the normal flow of bile is blocked, it starts to build up, and some of it leaks into the bloodstream ―– this can make the skin very itchy.”

One symptom of cholestasis is lower water levels in the womb. My doctor did an ultrasound scan, and we found that the fluid levels levels were indeed lower. We also did a blood test on my liver ― the results showed that my aminotransferase (ALT) results were six times higher than usual, while my aspartate aminotransferase (AST) results were twice as high. This confirmed the cholestasis diagnosis as ALT and AST are indications of bile acid levels.

My husband and I were worried as the blood test results weren’t good, nor was this a common condition among pregnant women here. Furthermore, obstetric cholestasis may increase the chances of a stillbirth. There is also an increased risk of your baby passing meconium while he is in the womb, which can irritate the baby's lungs if he breathes it in during delivery.

My gynae suggested that we make tentative plans to get my baby out earlier if needed, especially if my condition started to affect his health.

I was advised to keep myself as hydrated as possible, as this would help to flush out my liver. The treatment of the condition is mainly symptomatic, such as ways to relieve the itch, and monitoring baby till it can be delivered.

The only cure for cholestasis is to deliver the baby.