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[|Human|] Hi I am 22 weeks pregnant with my third baby. I have been having uncontrollable itching for the past two weeks, there is no rash associated with it, until I start scratching so hard it causes one or my skin to bleed. My Dr. did a Liver enzyme test and my ALC was 59, and my bile acid was 12, she said that it is normal, but everything I have read says you can have ICP with anything above 10 Bile acid
[|AI|]  Hi there,Homeostasis of pregnancy could be the cause of your itching. Did you have similar complaints in the later weeks of the previous pregnancies too? Itching without rash, almost normal liver enzyme levels and slightly raised bile acids, no other identified cause for itching definitely point towards Homeostasis of pregnancy. You need to consider tests to rule out hepatitis infection. The itching will increase with time, you will need symptoms relief with local application of creams such as calamine lotion and menthol and if itching increases Ursodeoxycholic acid can be considered, it decreases bile acid levels and receives itching. Also consider vitamin K supplementation after 36 weeks. Rarely Obstetric homeostasis can cause still birth, so fetal monitoring could be considered. Some women prefer to deliver after 37 weeks if the itching increases. You will need to do regular liver function tests and bile acid levels. Hope this helps. Regards.