Intrahepatic cholestasis of pregnancy

Intrahepatic cholestasis of pregnancy is the most common liver problem that shows up only during pregnancy. It usually appears in the second or third trimester, with itching, which doctors call pruritus, and with high levels of bile acids. Bile acids are one part of bile.

To understand it, follow the bile. Bile is a digestive fluid that the liver makes and that normally flows out of it. In cholestasis, a word that means the bile is standing still, that fluid has trouble getting out and gradually builds up. Because the backup happens inside the liver itself, it's called intrahepatic. Picture a bathroom sink with a half-clogged drain: the water doesn't go down the way it should and stays in the basin. Estrogen and progesterone, hormones that run higher during that stretch of pregnancy, are suspected of slowing the flow of bile acids.

The itching is thought to start when those bile acids build up in certain tissues. Notice where it usually begins: on the palms of the hands and the soles of the feet. And after delivery, the itching goes away quickly.