Elara guides

The itch that matters: cholestasis

Most itching is harmless — but this kind needs a call.

Itchy skin is common in pregnancy as your bump stretches and hormones shift. Almost always it's harmless. But one particular pattern of itching can signal a liver condition called intrahepatic cholestasis of pregnancy (ICP), which needs medical attention — so it's worth knowing the tell-tale signs.

The kind to flag

ICP itching is typically intense, often on the palms of the hands and soles of the feet, and frequently worse at night — sometimes bad enough to stop you sleeping. There's usually no rash. It tends to appear in the third trimester. If your itching matches this picture, contact your provider; a simple blood test checks your bile acids and liver function.

Ordinary, harmless itching

• Mild itching over a stretching bump, breasts or hips.
• Dry-skin itch that eases with moisturiser.
• A localised itchy rash (often its own, separate skin condition).
• Itching that isn't focused on palms and soles and doesn't keep you awake.

Why it matters

ICP raises the risk of complications for the baby, so when it's diagnosed you'll be monitored more closely, sometimes given medication to ease the itch, and your team may recommend planning the birth a little earlier. With monitoring, outcomes are usually good — which is exactly why catching it matters.

Intense itching — especially on palms and soles, or worse at night — is always worth a call, even if there's no rash. It's a quick blood test, and peace of mind either way.