Cholestasis during pregnancy prohibited foods. Plasmapheresis technique. Diagnosis and differential diagnosis

During pregnancy, the general condition of many women worsens, chronic disease or new ones appear that were not there before pregnancy. Cholestasis is a condition of a pregnant woman in which a large number of bile, and it stagnates. There is a violation during pregnancy, ends after the birth of a child. Pregnant women develop this disease (cholestasis during pregnancy) most often at a later date. This deviation develops in a small number of women, according to the observations of doctors, on average, one out of a hundred pregnant women falls ill. noted severe itching palms and feet, daytime discomfort practically does not occur, but at night the condition worsens, and the woman experiences excruciating itching. It reaches such strength that the pregnant woman combs the body until it bleeds. When the first symptoms appear, you should consult a doctor. If a woman misses a favorable moment and starts her condition, then this can harm the child. For the pregnant woman herself, the disease most often does not threaten anything, but almost twenty percent die in the womb. born babies. When the disease is noted:

malfunctions in the bile production system (stagnation);
production of bile in large volumes;
decrease in the flow of bile into the intestines;
adverse effects on the liver.

There are two types of the course of the disease:

violation only in the formation of bilirubin;
disturbance in the intake and excretion of bile secretions. IN this case the prognosis is unfavorable.

As practice shows, after the birth of a child, after two, a maximum of five days, all the symptoms of the disease disappear. Almost always there is a stabilization of the woman's health. However, it must be remembered that there is a high probability of recurrence of the disease with next pregnancy.

Causes of the disease

Intrahepatic cholestasis of pregnancy (ICP) - insidious disease. Research has not yet provided accurate results, and the causes of cholestasis have not been studied in detail. Doctors suggest that the most probable causes are:

heredity;
an excess of a hormone (estrogen);
squeezing internal organs a grown-up child, their displacement to a side atypical for the organ (this applies to the gallbladder and liver);
liver disease;
liver damage due to drug overdose;
cardiovascular insufficiency;
infectious diseases;
blood infection.

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The risk groups include the following pregnant women:

having previously sick relatives;
multiple pregnancy;
artificial insemination;
unsuccessful pregnancies ending in the death of the child in the womb or immediately after birth);
the presence of helminths in the body;
a case of cholestasis in a previous pregnancy;
mechanical damage liver;
Adoption combined contraceptives before pregnancy.

Manifestations of cholestasis

The disease can be according to the timing of occurrence:

acute (abrupt onset of the disease);
chronic (alternating manifestation of the disease and its attenuation).

During the period of the disease, the color of the skin changes:

pronounced yellow color of the skin, sclera, oral mucosa;
almost no color change.

With cholestasis of pregnancy, there are many symptoms. When a pregnant woman becomes ill, the following phenomena can be noted:

redness, itching of the skin, often this sign alone, only it indicates cholestasis;
rashes on the folds of the arms, legs, back;
specific and repulsive odor stool;
discoloration of fecal secretions;
change in urine color (dark);
visual acuity decreases, there is a threat of osteoporosis (bone fragility);
unreasonable weight loss.

In addition to the pronounced specific ones, there are symptoms that most likely occur during pregnancy:

dizziness and headache;
gas and belching;
inflammation of the pancreas;
tearfulness and irritability;
stomach upset;
It's a dull pain in back.

The first, very debilitating symptom is itching of the skin. In order to alleviate the condition of the expectant mother, it is recommended:

don't go out for a walk high temperature air;
wear things from natural materials;
sleep in a cool room;
air humidification in the house;
apply ice compresses to problem areas;
lubricate the places of scratching with creams with an anti-inflammatory effect;
avoid nervous excitement, take soothing teas, engage in auto-training.

Diagnosis and treatment of cholestasis

Sometimes the simplest procedure - palpation of the liver - is enough to determine the enlargement of the liver. But this technique not suitable for pregnancy.

An enlarged abdomen, displaced organs cannot give accurate information. Signs of cholestasis in pregnant women are varied. Therefore, for diagnostics are used:

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radiological scanning (damage or enlargement of the organ is determined by the advancement of isotopes);
laparoscopy (using video equipment and a tube);
computer research (dangerous on early dates);
study of the bile ducts with iodine substance.

Not all of these methods are suitable for pregnant women. Classic ways remain urine, blood and ultrasonography. Most often, the disease manifests itself in the second half of pregnancy, after the twenty-sixth week. Under the influence of the disease in the mother, the child may suffer from such pathologies;

lack of oxygen;
poisoning with bile acids that pass through the placenta.

If the condition of the child causes concern, then the woman is artificially delivered after thirty-four weeks. The child at this time is quite viable and decision does not provide negative influence on the baby's body. The attending physician monitors the course of the disease and the condition of the fetus. If the gestational age requires its extension, then it is prescribed drug treatment:

drugs are prescribed that optimize the movement of bile;
groups of vitamins A, K, D, E are prescribed;
antiallergic drugs;
balanced diet.

diet for cholestasis

The use of diets for cholestasis of pregnant women gives good results. The doctor can give certain recommendations, and you need to follow them in order to give birth at term. healthy baby. Key recommendations:

drink plenty of fluids, break portions into parts, take fractionally;
introduce more vegetables and fruits into the diet;
eat foods rich in vitamin C;
reduce the consumption of heavy food, refuse sauces, fried foods;
drink vegetable, fruit and herbal teas. decoctions, kissels;
exclude legumes from the diet;
reduce the amount of dairy products, especially fresh ones;
give up coffee, black tea.

It is necessary to help yourself and the child with the help of a complex of therapeutic measures to overcome the disease. It is necessary to remember the threats that arise for the life of the child and the health of the mother.

Complications caused by cholestasis

The percentage of births of children affected by maternal cholestasis is low. These are isolated cases. Observations show that unfavorable endings of pregnancies can be as follows:

Pregnancy may end caesarean section when primordial feces are found in the amniotic fluid.
In some cases, preterm birth occurs. The reason is the accumulation of bile acid in the fetal liver.
The occurrence of infection of the biliary tract of the fetus.
Bleeding on later dates.
Death of a child during childbirth.
Frozen late pregnancy.
Deviation in the structure of the digestive organs of the fetus.
oppression of the central nervous system fetus.

Alternative medicine treatment

There are many treatments available to improve cholestasis. Traditional medicine suggests using decoctions from the following medicinal herbs:

stigmas of corn;
St. John's wort;
immortelle;
dandelion roots;
milk thistle;
nettle;
maple;
rose hip.

The use of certain herbs and fees must be agreed with the attending physician. Treatment with traditional medicine goes like extra help body during drug treatment.

Disease prevention

At this stage in the development of medicine, there is no effective ways to protect against disease. It is necessary to carefully monitor your condition during pregnancy and consult a doctor at the first sign. In case of cholestasis of pregnant women, it is necessary to strictly follow the doctor's prescriptions and not self-medicate. You need to follow a strict diet and not get hung up on the current situation. Move more, walk, find a hobby. The community of the attending physician and the expectant mother will help to overcome the disease and due date give birth to a healthy child.

During the period of bearing a baby, a woman's body experiences a double load, and therefore its defenses weaken. Against this background, various pathological conditions. One of them is cholestasis. What is this ailment? How dangerous is he? How is it traditionally treated during pregnancy? Let's answer these questions.

Briefly about the disease

This disease in the language of therapists sounds like intrahepatic cholestasis of pregnancy (ICP). It is a liver disease with a violation of the passage of bile through the bile ducts and a subsequent increase in the concentration of bile acids in the blood of the patient. The reasons for this phenomenon, doctors call hormonal changes in the body of a woman, as well as heredity. If the parents of the expectant mother had problems with the liver, she herself encountered them even before conception, then during the period of bearing the baby, they can again make themselves felt. Also, the risk of intrahepatic cholestasis increases with multiple pregnancies. If the pathology occurred during previous pregnancies, then in subsequent pregnancies the chances of relapse increase.

Signs of cholestasis in pregnancy

According to statistics, intrahepatic cholestasis develops in most cases in the third trimester of pregnancy. More often it occurs in the cold season. A typical symptom of ICP, and sometimes the only one, is severe itching of the area of the feet and palms. The itch itself different parts body during pregnancy is not uncommon. But with cholestasis, it is these parts of the body that itch. Sometimes itching can spread to the face and neck. It can be very intense, which negatively affects sleep and general well-being. future mother. It can itch up to the formation of wounds.

If we are talking about mild cholestasis and medium shape in the third trimester of bearing a child, then the itching stops a few days after childbirth. Then the work of the gallbladder and kidneys is normalized.

In a severe form of the disease in a pregnant woman, manifestations of other symptoms are possible. They look like signs of jaundice. These are nausea, dark urine, yellowing of the whites of the eyes and skin, whitish feces, and vomiting.

It is worth knowing that such a condition is dangerous for the unborn baby. The risk of pathology is that childbirth can be. The baby can die in utero or in the first hours of his life. In such cases, meconium will get into amniotic fluid. For the woman herself, the danger of intrahepatic cholestasis lies in postpartum bleeding, and strong.

Diagnosis of pathology and treatment

In most cases, this diagnosis is confirmed by laboratory blood tests. Given all the above risks, such a woman is subjected to close observation. Experts may advise her to give birth earlier due date, up to 37 weeks. In this case, the woman is prescribed medications that reduce the risk of pregnancy complications. Drug treatment consists in taking vitamin K, ursodeoxycholic acid, antacids.

As for the appointment to relieve the symptoms of itching, in this case they are ineffective. Yes, and such a drug load is highly undesirable, it can cause negative effects. Therefore, antihistamines are not prescribed for intrahepatic cholestasis of pregnant women.

But adherence to a diet is a prerequisite for treatment. The doctor recommends that the woman eat fractionally, drink plenty of fluids. The basis of the diet should be fruits, cereals, vegetables. Plant foods should be rich in fiber and ascorbic acid. These are lettuce, spinach, broccoli, citrus fruits, bell peppers. Low-fat dairy products, black bread, fish are recommended. To a minimum it is necessary to reduce the amount of animal products and fats. It is strictly forbidden to eat fatty meat, butter, mayonnaise, store-bought sauces, fried foods.

As for the liquid, in addition to clean filtered water, you need to drink decoctions of berries, fruits, herbal teas, infusion, freshly squeezed grapefruit juice. You can not drink coffee, green tea.

To relieve the symptoms of itching, doctors advise applying ice to the palms and feet. It slows down the blood flow - and thus the itching calms down.

During pregnancy, nervous shocks negatively affect the condition of a woman. At this moment, it is not always possible to protect the expectant mother from dangers. Cholestasis of pregnancy often occurs. A diet for cholestasis of pregnant women and following the doctor's recommendations will help to cope with the problem.

Symptoms

There comes a time when the sensitivity of the liver increases. There is a failure of hormones that begin to react. As soon as the flow of bile to the intestine decreases, the accumulation of bile salts and acids in the blood begins. The diet for cholestasis of pregnant women will solve the issue in this situation. Every woman should follow certain rules behavior.

The last trimester of pregnancy often brings a surprise in the form of itching. The doctor prescribes tests that will help determine the presence of acids in the blood. In addition, jaundice appears.

A woman with cholestasis feels weak, sleep is disturbed, depression occurs. There are also symptoms such as vomiting and heaviness after eating.

To reduce itching use:

cream with chamomile;
clothing made from natural fabrics;
soothing mint tea;
it is better for a woman to stay at home in hot weather;
ice can be applied.

This approach in short time restores the normal rhythm of life of the expectant mother and baby. Compliance with doctor's prescriptions, use of funds traditional medicine helps reduce symptoms.

Food

In addition to these tips, proper nutrition with cholestasis of pregnancy. It is advisable to exclude fried and fatty foods reduce the amount of dairy products consumed. This will help ease the work of the liver. It is recommended to use homeopathic remedies prescribed by a specialist.

Cholestasis of the liver during pregnancy means that you need to pay attention physical activity, take more fluids. A diet for high cholesterol in pregnant women should be prescribed by a doctor.

adhere to fractional nutrition;
increase the amount of vegetables and fruits, foods with an increased presence of vitamin C and calcium;
spinach, fish, low-fat dairy products should be present in the diet;
the minimum consumption of fatty meat and butter is supposed;
allowed in small quantities vegetable oil and margarine. They are necessary for the development of the baby;
you should use herbal tea, juices, decoctions of berries, rose hips, grapefruit juice.

Treatment

Prohibited foods for cholestasis of pregnancy:

you can not eat soups based on fatty meat;
you need to refrain from hard-boiled eggs;
loads the liver with garlic, green onion feathers, spinach, radish;
mayonnaise and sauces have a bad effect on the work of the pancreas;
avoid eating cauliflower, melon, olives, avocados;
you can not drink coffee and green tea;
chocolate.

It is on this list that there are products that impede the work of internal organs.

What to do with high cholesterol in pregnant women? It is worth starting with monitoring the causes of the manifestation of the disease. It is necessary to carry out preventive actions. They include:

reception medicines;
diet;
physiotherapy and exercise therapy.

A pregnant woman should do recreational gymnastics, walk more on fresh air, visit the pool. It is recommended to refuse bad habits, control body weight and take tests for cholesterol. Be sure to follow all the doctor's recommendations.

Proper nutrition

The norm of cholesterol in pregnant women in the 2nd trimester differs depending on the age of the woman. The figure can be doubled. Cholesterol 10 in a pregnant woman often manifests itself at the age of about 20 years. Since the indicator for a woman who is not pregnant is up to 5.5.

Table - Norm of cholesterol in pregnant women by age

juice from celery and carrots;

cucumber, beets and carrots;

cabbage, carrot or apple juice;

Thus, the pregnant woman will support and normalize the condition, prevent a re-increase in cholesterol.

Many people during pregnancy are interested in the question of whether there are ways to prevent cholestasis of pregnancy. The main thing is to constantly see a doctor. To get rid of the symptoms, hepatoprotectors, antioxidants and choleretics are prescribed.

It is important to follow a diet and take tests on time. This will make it possible to determine the deviation on early stage, eliminate violations and maintain a healthy fetus.

Any pregnant woman experiences great stress during this difficult period of time for her. IN female body there is a restructuring hormonal background, his abrupt change can provoke some diseases or lead to their complications. One of these diseases is cholestasis of pregnancy, which is observed if the woman's liver is very sensitive and can react sharply to changes in the hormonal background.

Such a condition during pregnancy can harm the health of the woman herself, but to a greater extent threatens the health of the child, That's why future mom needs timely therapy. What is this dangerous disease and what are its symptoms, what can suggest modern medicine in helping?

Intrahepatic cholestasis of pregnancy

This rare liver disease, which can occur during pregnancy, the organ is affected because it becomes very sensitive in such a crucial period for a woman. The liver is the organ that takes care of Active participation in many metabolic processes in the body.

All these functions can be impaired in liver disease, when the parenchyma of the organ is damaged. The liver tends to synthesize bile, which, after synthesis, enters the intestine through the bile ducts and then takes part in digestion. The cause of cholestasis during pregnancy is a decrease in the amount of bile discharged to the intestines, then bile salts begin to accumulate in the blood.

During pregnancy, there may be violation of the process of normal metabolism bile acids and cholesterol. All this leads to a malfunction of the whole organism. With cholestasis of pregnancy, the liver is affected from the inside, this problem is usually faced by those women who consume a lot of fat, which has a very negative effect on the liver.

In the countries of Central Europe, cholestasis occurs infrequently, it affects women most of all Latin America, China and Scandinavian countries. The main danger is that preterm labor may begin and there is a risk of losing the child, since there is a threat to his life. A woman in labor can immediately open heavy bleeding, which is also a risk to her health.

Cholestasis of pregnancy symptoms

Usually on last trimester pregnancy, the disease begins to manifest itself very strongly. Most often, a woman complains about severe skin itching especially at night. It often happens that the itching becomes so severe that sometimes it can lead to scratching before the appearance of blood. The first to suffer from itching are the palms and feet, and then the condition worsens and almost the entire body begins to itch.

Also indicative of cholestasis dark color urine and light feces if the disease becomes chronic, then pain manifests itself in the form of hyperpigmentation of the skin. It can often be observed in the chronic course of the disease, when flat and convex spots appear on the skin. soft formations yellow color . They are most noticeable on the neck, back, in the folds of the palms, under the mammary glands and around the eyes.

When cholestasis begins to be severe, it can cause depression and lead to sleep disturbance, there may also be nausea and vomiting, heaviness after eating. Itching directly depends on the severity, this is due to the level of acids in the blood. The diagnosis can be established accurately if you take a blood test or do an ultrasound of the liver, in rare cases they are forced to do a biopsy.

Possible complications in pregnant women

Cholestasis does not pose a big risk to the life of the expectant mother, but it can harm health. Itching will sometimes appear after pregnancy and there will be a problem with malabsorption of fat-soluble vitamins. Some time after childbirth, liver problems will not appear.

The life and health of the unborn child is at greater risk, there is a greater probability premature birth , in late pregnancy, this can lead to fetal death. When labor comes and the baby is born, he can inhale meconium, which makes it difficult for him to breathe. In case of serious complications, the doctor is forced to offer the woman in labor to do an artificial birth. Later, when a woman becomes pregnant again, there is a relapse of cholestasis of pregnancy.

Usually, all pregnant women suffering from cholestasis are prescribed two types of drugs. One of the drugs Ursosan, helps to reduce itching or eliminate it, normalizes bile acids, the liver begins to function normally. Steroid drugs- Dexamethasone is also prescribed for illness. Vitamin K, which enters the body of a pregnant woman along with food, improves blood clotting.

Doctors often prescribe vitamin K to women and they take it before labor occurs. This vitamin is also able to protect the baby in the womb. The purpose of the prescribed therapy is to exclude the possibility of the death of the child. The condition is periodically monitored with ultrasound, and the optimal time for termination of pregnancy may occur after 35 weeks to 38 weeks inclusive. This period of time gives a greater likelihood that the child will survive. If not done artificial stimulation childbirth, then guarantee successful delivery at a later date, no one can.

A woman must review your diet, try to exclude fatty and fried foods from the menu, eat less dairy products, drink more fluids. There are several ways to relieve itching.

Use calamine lotion
Use creams with calendula or chamomile
Wear clothes made from natural fabrics that do not restrict movement.
Try not to go outside in extreme heat or high humidity.

When the baby is born, he is prescribed vitamin K, and if the newborn weighs less than 2.7 kg, then he needs additional treatment, which is prescribed by neonatologists after examination.

It is unlikely that it will be possible to protect yourself from a disease such as cholestasis of pregnant women by 100%, therefore, doctors recommend that women who are at risk be constantly monitored throughout pregnancy. Doctors usually prescribe preventive treatment even before the onset of symptoms as mild antioxidants, hepatoprotectors and choleretics. They recommend sticking to proper diet visit the doctor on time and take tests. Such measures will allow to identify the disease at an early stage and prevent its complications.

To improve digestion processes, it is recommended to take herbal teas, and in order to avoid bile stagnation, they prescribe herbal preparations , since it is the stagnation of bile that leads to cholestasis of the pregnant woman. Dehydration can also cause bile stasis, so you need to maintain a water regime and drink more pure natural water. It is also recommended for expectant mothers to lead an active lifestyle, to do fitness for pregnant women.

Conclusion

Some women face the diagnosis of cholestasis of pregnancy. In order to avoid complications, it is better to undergo full examination with change necessary analyzes . If pregnancy has already begun, then visit the doctor on time, when the disease is detected, adhere to all recommendations for treatment. As practice shows, the timely detection of the disease, its treatment helps to keep the fetus healthy and eliminate disorders in the body of the expectant mother.

Bearing a baby is not only a joyful period of waiting for the birth of a new person, but also a serious burden on the body of a woman “in position”. In some cases, individual organs or even systems do not withstand the enhanced mode of operation and fail. One of the problems that a future mother may face is cholestasis. How does this pathology manifest itself? Is hepatic cholestasis dangerous during pregnancy? What methods of treatment are used in therapy in the gestational period?

The term "cholestasis" characterizes a pathology in which the process of normal production and outflow of bile from the liver is disrupted. While waiting for the baby this disease most often provoke hormonal changes in the mother's body. Additional predisposing factors are multiple pregnancy and heredity. If a woman has before the onset of " interesting position» had liver problems or one of her parents has a disease of the biliary system, the likelihood of cholestasis increases. Also, the risk of developing pathology increases if cholestasis occurs during previous pregnancies. As a result of the disease, the liver and bile ducts are affected, the natural removal of bile is disturbed. Bile acids enter the bloodstream, thereby causing a deterioration in the well-being of the pregnant woman.

Cholestasis during pregnancy - symptoms of the disease

Violation of the functioning of the organs of the biliary system can occur and is not very noticeable. And yet some characteristics cholestasis occurs during pregnancy. A woman should definitely seek medical advice if:

The color of feces and urine has changed - the urine has become darker, and the feces, on the contrary, have become lighter and even whitish.
There was severe itching of the skin. It is noticed that a more intense desire to comb the skin occurs in the evening and at night. Itching can cover both the whole body and its individual parts. Particularly strong anxiety occurs in the area of the feet and palms.
A woman may experience nausea, vomiting.
Possible yellowing skin, whites of the eyes, a pregnant woman may notice the appearance of yellow-brown spots on the skin.

The appearance of any of these symptoms requires additional attention to the woman's health. Additional testing is recommended.

Tests for cholestasis during pregnancy

The diagnosis of "cholestasis" is established on the basis of complaints of a woman, clinical picture disease, as well as the results of tests and examinations. The latter include:

general blood analysis;
general analysis of urine;
blood biochemistry (determination of the level of bilirubin and indicators of liver enzymes);
performing ultrasound of the liver;
liver biopsy - in extreme cases.

If intrahepatic cholestasis during pregnancy is confirmed, the woman is prescribed a therapeutic diet, drug therapy and moderate physical activity. Since in most cases the pathology is provoked by the “special situation” itself, the therapy of the disease is aimed at reducing the manifestations of cholestasis.

Cholestasis in late pregnancy

Most often, the disease manifests itself already in the third gestational trimester - after the 28th week. However, do not miss alarm bells that arose at earlier dates, depending on individual features the body and the course of pregnancy, the disease can attack in the first trimester of waiting for the crumbs. The tactics of therapy depends on the duration of pregnancy and the degree of the disease - the first, second or third.

In the first case, skin itching is mild. Other clinical manifestations illnesses are absent. Laboratory analyzes show a moderate deviation from the norm and not for all indicators. In this case, the pregnancy is prolonged, nothing threatens the health of the baby.
The second stage of the disease is characterized not only by a pronounced skin itching, but also a significant deviation (3-6 times) of ALT and AST, hemostasis indicators are also impaired. Deviations were also identified by the results of ultrasound. The second degree of cholestasis already poses a threat to normal development and the life of the crumbs - the likelihood of fetoplacental insufficiency and delay increases significantly prenatal development baby.
The third degree of cholestasis is the most severe and dangerous. In this case, in addition to clinical symptoms and deviations in laboratory tests, gastroenterological disorders are noted, normal blood clotting is disturbed. This situation poses a danger to both the life of the crumbs and the life of his mother. In this case, emergency delivery is indicated.

Violation of the processes of bile formation and its removal poses a threat to the health of both the woman and the baby in her womb. Why is cholestasis dangerous during pregnancy? In the absence of treatment or with unsuccessful therapy of cholestasis, the following complications are possible.

For woman:

Opening of bleeding (due to a decrease in the level of vitamin K).
premature birth.
The formation of stones in the organs of the biliary system.
Loss of bone density.
Liver failure.

For baby:

When diagnosing cholestasis, the most terrible complication of the disease is the death of the crumbs in the womb or in the first 7 days after birth. For this reason, doctors rarely bring pregnancy to the prescribed 38-40 weeks of gestation. Delivery is most often performed between 35 and 38 weeks.

Among other complications, it is worth highlighting:

Oxygen starvation of the baby, insufficient intake of nutrients, which leads to his developmental delay and even death.
Low birth weight of the baby.
The presence of immune disorders in the crumbs, problems with the functioning of the digestive tract, hearing loss.

Treatment of cholestasis during pregnancy

Treatment for the disease includes A complex approach, important place among the methods of which is drug treatment. A woman is assigned:

Drugs with ursodeoxycholic acid (for example, Ursofalk, Grinterol, Ursosan). Medicines of this group protect liver cells, bind and remove toxic formations (excess bile acids).
Medications to stimulate metabolic processes (Hofitol, Heptral).
Antacids and sorbents. Medicines this category is also designed to remove excess bile acid - Maalox, Almagel, Phosphalugel.
Vitamin-mineral complexes, an essential component of which is vitamin K.
According to the indications, it is possible to prescribe hepatoprotectors (Essentiale).

The appointment of drugs of the antihistamine group does not occur due to the low effectiveness of the latter in this disease.

Nutrition for cholestasis during pregnancy

The key point in the treatment of cholestasis during the waiting period for a toddler is correctly organized meals. A woman "in position" needs to adhere to certain principles in organizing her daily diet.

Principles of nutrition for cholestasis during pregnancy

First of all, you should exclude:

Fried foods, fats and fatty foods. The optimal solution will be steamed dishes.
It is also not recommended to include first courses based on fatty meat in the menu.
Dairy products are high in fat.
Oily fish.
Boiled chicken eggs.
Green tea, coffee.
Chocolate.
Carbonated drinks.
Convenient products.
Legumes and cereal products.
Spinach, garlic, green onion feathers, radish, radish, mushrooms, eggplant.
Mayonnaise, sauces and other fatty or spicy dressings.
Melon, figs, grapes, persimmon, pear, date, tangerine - also not the best choice with cholestasis.

But what needs to be done is to increase consumption:

Liquids. Will be especially useful pure water, tea, compotes, juices, berry decoctions.
Vegetables and fruits rich in vitamin C and fiber.
Celery, carrots, cucumbers, cabbage (Beijing and cauliflower), pumpkin, zucchini and beets.
Prunes, dried apricots, banana, sweet and soft apples, watermelon.
Lean meats and fish.
Sour-milk and dairy products of low fat content or completely skimmed
Bran bread.
Olive oil promotes normalization general condition, reduces the severity of inflammatory processes.
avocado and fish fat help lower blood cholesterol levels.
The diet should contain cereals (buckwheat, rice, oatmeal, couscous, bulgur), muesli.
Vegetable oil must be present in minimum quantity, because it is necessary for the normal development of the baby.

Don't forget about fractional nutrition- overeating and long periods fasting is best avoided. The food consumed should be at a pleasant temperature (not too cold or hot). The basis of everyday nutrition should be the "Table No. 5" diet, the main purpose of which is to reduce the load on the liver and gallbladder.

Sample menu during pregnancy with cholestasis

1st meal (shortly after waking up). A glass (200-250 ml) of ordinary water or mineral water without gas.
Breakfast. Porridge (barley, oatmeal) with or without dried fruits. Syrniki. Kissel or juice. An alternative to porridge can be milk noodle soup, rice casserole or dumplings with cottage cheese.
2nd breakfast. cottage cheese or fruit salad. Herbal tea or rosehip decoction. Galette cookies.
Dinner. Vegetable soup, steam cutlets(or baked chicken, or boiled fish). Vegetable stew. Compote or fruit drink.
afternoon tea. Fresh fruits or vegetables. Green tea.
Dinner. Omelet, steamed fish. Juice. Alternative option- porridge or mashed potatoes, steamed meat or fish cutlets (meatballs), herbal tea.
1-1.5 hours before going to bed. A glass of low-fat kefir or yogurt.

Cholestasis during pregnancy - photo

Cholestasis during pregnancy - reviews

Ksenia:“She gave birth on her own with cholestasis at 37 weeks (started at 29 weeks). The cervix was prepared and the bladder was pierced. The baby was born on 8/9, everything is in order with health. Up to the birth, she drank Urosan and dripped Heptral, there was also constant monitoring of CTG.
Svetlana:“The problems started in the third trimester. In the hospital she took Heptor (dripped) and Ursofalk. Biochemistry indicators fell by half. She gave birth at 39 weeks after stimulation. The child is healthy."
Olga:“Slight itching began to bother me from the first trimester, but at 28 weeks it became unbearable. At week 32, the test scores went off scale. From 32 to 36 weeks she was in the hospital, Heptral was dripped. Well helped. She gave birth at 38 weeks. The waters are clear, the child is all right.”