Why does obstetric cholestasis cause itching in pregnancy?

Obstetric cholestasis affects how bile moves through the liver during pregnancy. Bile acids may enter the bloodstream and trigger intense itching, often on the palms and soles, sometimes without a rash. Symptoms can be worse at night and may spread to other parts of the body. Itching in pregnancy also has other causes, so the symptom needs assessment rather than self-diagnosis.

Tell your midwife, obstetrician, or maternity unit about new or persistent itching, especially on your hands or feet or when it disrupts sleep. Blood tests can check liver function and bile acids; results may need repeating if itching continues. Cool showers, loose cotton clothing, and an unperfumed moisturiser may reduce skin irritation. Use medicines only after checking that they are suitable in pregnancy.

Contact your maternity team promptly if itching is intense, rapidly worsening, or accompanied by yellow skin or eyes, dark urine, pale stools, abdominal pain, or reduced baby movements. Reduced movements need urgent assessment at any stage of pregnancy.

Ask which blood tests are needed, when they should be repeated, how symptoms and your baby will be monitored, and what treatment or birth planning may be considered if obstetric cholestasis is confirmed.