Obstetric Cholestasis
Professor Catherine Williamson
Jenny Chambers is someone who knows only too well the heartache of stillbirth. Her daughters Victoria and Olivia were stillborn in 1986 and 1991.
Obstetric cholestasis is a pregnancy-related liver disorder that affects 1 in 200 pregnancies. It presents with itch in the mother in association with liver impairment and raised bile acids in the blood. Although there is no risk to the mother the condition can result in the premature delivery and stillbirth for the baby. This happens towards the end of the pregnancy and with no warning.
Our research focuses on genetic factors that cause pregnant women to be susceptible to obstetric cholestasis, and on identifying the reasons why unborn babies die suddenly or are born prematurely. We have already identified several genes that predispose women to obstetric cholestasis and we are currently extending the work to evaluate whether women with genetic abnormalities respond better to specific drugs.
We suspect that in obstetric cholestasis the high levels of bile acids in the mother’s blood cross the placenta to the blood of the unborn baby. We further suspect that these bile acids cause the babies heart to stop beating, and this may explain why they die suddenly. We are working with heart cells to develop treatments that will protect the heart from the harmful effects of bile acids. This work together with our focus on genetics will, we hope, help us to understand the condition more fully so that the risk of stillbirth or premature delivery is minimized and women who have obstetric cholestasis will experience less anxiety as a result.