Home › Pregnancy › Week 40 › Cholestasis of Pregnancy
Week 40 · Third Trimestersevere

Cholestasis of Pregnancy at 40 Weeks Pregnant

Intrahepatic cholestasis of pregnancy (ICP) is a liver condition causing intense itching, especially on the hands and feet, in the third trimester. It requires medical evaluation as it is associated with increased risk of stillbirth.

👶 What's Happening at Week 40

Your baby is now the size of a small pumpkin.

  • The baby is fully developed and ready for life outside the womb.
  • Lungs are producing enough surfactant for independent breathing.
  • The skull bones are soft and can mold for passage through the birth canal.

🔬 Why You're Experiencing Cholestasis of Pregnancy at Week 40

  • Pregnancy hormones impair normal bile flow from the liver, causing bile acids to accumulate in the blood
  • Genetic predisposition — more common in women with a family history or South American ancestry
  • Twin or multiple pregnancy increases risk
  • Prior liver conditions increase susceptibility

💊 Relief Tips for Week 40

1
Ursodeoxycholic Acid (UDCA)This medication (prescribed by your provider) reduces bile acid levels, relieves itching, and may improve fetal outcomes.
2
Cool BathsCool water can temporarily soothe itching.
3
Loose, Breathable ClothingAvoiding heat and friction reduces the intensity of itching.
4
Calamine LotionTopical calamine lotion may provide temporary itch relief.
5
Close Fetal MonitoringYour provider will likely recommend non-stress tests and additional monitoring to assess fetal wellbeing.

📋 Other Week 40 Symptoms

Extreme pelvic pressureStrong Braxton Hicks or early laborCervical dilationExhaustion and impatienceLoose stools
See full Week 40 guide →

⚠️ Call Your Doctor If…

  • Intense itching on your palms and soles, especially at night, in the third trimester
  • Itching all over your body without a visible rash
  • Yellowing of skin or eyes (jaundice) — less common but important
  • Dark urine or pale/gray stools

Frequently Asked Questions

How is cholestasis diagnosed?

Your provider will order a blood test measuring serum bile acid levels and liver function tests (ALT, AST). A bile acid level above 10 µmol/L confirms the diagnosis.

Does cholestasis harm the baby?

Elevated bile acid levels are associated with preterm birth, fetal distress, and in severe cases, stillbirth. Close monitoring and early delivery (typically by 36–37 weeks) reduces these risks.

Is ICP itching different from normal pregnancy itching?

ICP itching is characteristically intense, worse at night, located on the palms and soles, and has no visible rash. Normal pregnancy skin itching is milder, associated with stretching skin or a visible rash.

Will cholestasis come back in future pregnancies?

Yes — women who have had ICP have a 60–90% chance of recurrence in subsequent pregnancies.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult your OB/GYN or midwife about symptoms during pregnancy.