Understanding High Cholic Acid in Pregnant Women: Causes, Symptoms, and Treatment

[Health Channel/Comprehensive Report]A 35-year-old pregnant woman, 30 weeks pregnant with twins, was very uncomfortable due to skin itching. She was transferred from an obstetrician to a dermatologist, and then found to have an abnormal liver index, and then transferred to a gastroenterologist. After medical examination, blood test, and abdominal ultrasound, it was found that the cause was excessive bile acid.

Zhan Yixue, Director of the Endoscopy Department of Hexin Minquan Health Management Clinic, posted on the Facebook page “Dr. Zhan Yixue, Department of Hepatobiliary GastroenterologyThe article pointed out that excessive cholic acid in pregnant women is also known as intrahepatic cholestasis during pregnancy. The main causes are due to hormonal changes, (increased estrogen, usually higher chance of twins), environmental factors, genetics, drugs, hepatitis C and other factors.

The clinical symptoms of hypercholic acid in pregnant women generally have the main symptoms: itching all over the body, usually in the middle and late stages of pregnancy, most of the skin does not have rashes, and experienced dermatologists can diagnose cholestasis and abnormal liver function. Disappeared after delivery; other symptoms like insomnia, loss of appetite, tiredness, upper abdominal discomfort, etc. Possible complications include placental failure, premature delivery and increased chance of stillbirth.

Drug and diet control treatment to avoid cholestasis

● Drugs: reduce cholestasis.

●Diet control, it is recommended to eat a light diet, less oil and less salt, eat more vegetable dietary fiber, whole grain food, and eat more fruits.

Zhan Yixue pointed out that there are many reasons for cholestasis and jaundice. Even pregnant patients must rule out the following reasons: liver tumors, liver inflammation (type A, type B, type C, alcoholic drug-induced hepatitis), liver cirrhosis, Cholestasis caused by gallstones, biliary obstruction, etc.

Zhan Yixue also arranged the following checkups for the pregnant woman:

1. Physical examination: the sclera is white in color, and there is no tenderness in the right upper quadrant.

2. Blood test: total bilirubin, direct bilirubin were normal, hepatitis B and C were negative.

3. Abdominal ultrasound: moderate fatty liver, no gallstones, no biliary obstruction leading to expansion.

Zhan Yixue reminded that if you encounter high cholic acid during pregnancy, you need the joint diagnosis and care of a team of doctors to find out the cause of high cholic acid and abnormal liver function, so that you can receive treatment in the golden period and avoid serious consequences. Just like this pregnant woman, what she needs is the joint help and diagnosis and treatment of obstetricians, dermatologists, and gastroenterologists. Therefore, in many cases, the occurrence of a disease is not just a problem of one department.

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