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Gestational cholestasis is a liver disease characterized by itching, elevation of liver enzymes and increase in serum bile acids in the last 3 months of pregnancy. These findings usually disappear within 2-3 weeks after pregnancy.

WHAT ARE THE SYMPTOMS?

            Itching is the main symptom. The itching is disturbing and arouses sleep. It is most often on the palms and soles of the feet, but it can also spread to the whole body. Jaundice, weakness, loss of appetite and abdominal pain are rare symptoms.

            Diagnosis; It is detected by elevation of liver enzymes in the blood and elevation of serum bile acids. The diagnosis is made when the serum bile acid level exceeds 10 μmol/L. When the serum bile acid level exceeds 40 μmol/L, the likelihood of fetal complications increases.

            Premature birth and related complications, meconium aspiration and sudden fetal death are the conditions that can be seen in the baby.

HOW SHOULD THE TREATMENT AND MANAGEMENT BE?

            The aim is to relieve the mother's complaints, correct biochemical abnormalities and prevent the negative effects of the disease on the fetus.

            Increases in serum bile acids correlate with adverse effects on the fetus, and unfortunately, non-stress testing, ultrasonography, and maternal monitoring of fetal movements are insufficient to predict fetal well-being. In the light of current scientific data, the recommended recommendation is to perform non-stress testing twice a week.

            Ursodeoxycholic acid is used in treatment. It has been shown that ursodeoxycholic use reduces itching, serum bile acid level, and ALT level.

WHEN SHOULD BIRTH HAPPEN?

Studies show that it is appropriate to give birth at the 37th week. Stetoid should be applied beforehand to support the maturation of the fetal lungs. It is known that the use of ursodeoxycholic reduces itching, serum bile acid level, and ALT level, but has no effect on sudden fetal death.