Cholestatic pruritus in pregnancy: what to know

Pruritus means itching. In pregnancy, cholestatic pruritus is associated with changes in bile flow and often has no primary rash. It may be stronger at night and may involve the palms or soles, but the pattern varies. Blood tests for bile acids and liver function help the maternity team assess the situation and decide on follow-up. A rash, blisters, or marked scaling may instead suggest Atopic Dermatitis, Skin Yeast Infection, or another skin condition.

Contact your maternity team when new, persistent, or intense itching begins. Record its location, timing, effect on sleep, and any changes in urine, stools, skin colour, or fetal movement. Use cool compresses, loose clothing, and fragrance-free moisturiser for comfort. Avoid self-prescribing medicines or supplements; pregnancy changes which treatments are appropriate and how monitoring is arranged.

Ask for prompt advice if itching is severe, spreads, or continues despite comfort measures. Seek urgent maternity help for reduced fetal movement, yellowing of the eyes or skin, dark urine, pale stools, severe abdominal pain, repeated vomiting, confusion, or fainting. These signs need direct assessment rather than online comparison with other causes of itching.

Ask how bile-acid and liver tests will be interpreted, whether they need repeating, what monitoring is planned, and which treatment options are suitable at your stage of pregnancy. Confirm who to call outside clinic hours and how to report reduced fetal movement.