What causes bleeding in a pregnant woman with cholestasis?

Question

Hi doctor,

I am 15 weeks pregnant now. This is my first pregnancy. I have had cholestasis since the 8th week. I am currently taking Ursodeoxycholic acid, but it is not effective. Now in the last couple of days, I have started bleeding without pain. I am taking Tranexamic acid for 3 days and progesterone for 10 days. I have done ALT (alanine transaminase), which was 350 U/L initially but reduced to 110 U/L after TPN (total parenteral nutrition). But it again raised to 364 U/L. What is the reason for my bleeding? My placenta is 1.2 inches away from my internal os. Please tell me if the bleeding is due to cholestasis or some other reason.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Cholestasis, a liver condition that affects the flow of bile, typically does not directly cause bleeding during pregnancy. However, cholestasis can increase the risk of certain complications such as preterm birth or fetal distress, which could potentially lead to bleeding. In your case, the bleeding might be due to a different reason unrelated to cholestasis. There are several potential causes of bleeding during pregnancy, including but not limited to:

Implantation bleeding: Light bleeding or spotting can occur around the time the fertilized egg implants into the uterine lining.
Cervical changes: The cervix can be more sensitive during pregnancy and may bleed easily, especially after sexual intercourse or a pelvic exam.
Placenta-related issues: Conditions such as placenta previa (when the placenta covers the cervix) or placental abruption (premature separation of the placenta from the uterine wall) can cause bleeding.
Infection: Certain infections, such as a urinary tract infection or sexually transmitted infections can lead to bleeding during pregnancy.
Miscarriage: Unfortunately, bleeding can also be a sign of a miscarriage or impending miscarriage. However, it is worth noting that not all bleeding in pregnancy indicates a miscarriage.

Feel free to contact me for further queries.

Thank you.