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Childbirth

Has anyone made it to term with obstetric choleostasis

10 replies

Sodabread · 03/08/2015 19:57

I had obstetric choleostasis in my first pregnancy. However, it was quite mild, and so only really picked up around my due date, and it seemed my bile acids did not spike until I was already 9 days overdue. At that point I was induced, and everything turned out fine. Because of my history, this pregnancy they are closely monitoring me. My liver function tests have been going up and down, and bile acids have not yet spiked and I'm 36 weeks. I suspect they may begin to rise though, and am concerned they will suggest induction soon. I am keen to get to term, because I am worried that an induction at 37/38 weeks is different to being induced at 40 and 9, and that there may be more complications needing more intervention. However, I am aware of obstetric choleostasis risks, and so don't want to put baby at risk. As everything was fine last time and I was overdue, I am aware I may be being a little too laid back about this, and so was wondering what other peoples experiences were of making it to due date?

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Binit · 03/08/2015 20:07

I didn't make it to my due date either time. I was induced at 36+6 and 37+0.

The 2nd birth that your body does is usually easier - as in your body knows how to get the baby out and does it quicker. My first induction took ages, epis and forceps. My 2nd was not only quicker but I did not have any other interventions, just a bit of gas and air at the end.

As for the babies - lots born at this gestation look and behave as though they went to term, particularly girls. My ds was skinny with a weak latch but I did manage to feed him anyway. He could have done with a bit more time inside! My dd looked like a term baby and was completely fine.

I personally did not like the risks so agreed to get induced early.

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whootwhoot · 03/08/2015 21:59

I've recently battled with this dilemma - my consultant was keen to induce bang on 37 weeks - DH and I both nervous that was too soon however my bile acids were off the charts, the itching incredible and I ended up induced on 37+3 delivering 37+5. In terms of intervention, I had the pessary for 24 hours after which I was 2cm and the midwife performed a sweep - 2 hours later my waters went and mild contractions started. I was only in active labour (after being attached to the drip) for 3.5 hours and survived on gas and air only. DD was 6lb 6 with no respiratory or health issues. Looking back, I'm glad we did it when we did but it certainly was a big decision. All the evidence base is open to interpretation and no real studies have been conducted recently which has you second guessing yourself a lot!
Next time (if there is a next time!), with monitoring and hopefully getting on Urso sooner, I'd like to manage it to 38-39 weeks although if I had to induce again at 37, I'd feel ok about it.
Good luck - it is a difficult decision. Flowers for your dilemma

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Sodabread · 04/08/2015 16:57

Thanks, yes it seems a real dilema...saw the consultant today and bile acids are 15, so I have been started on urso and will have twice weekly monitoring, so will see what happens...

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whootwhoot · 05/08/2015 08:16

That sounds promising actually...they get keen to induce once the levels get to 40 but hopefully the urso will kick in and help stabilise. My bile acids peaked at 192 Blush. Had they been lower than 40 I think I would have pushed for more frequent monitoring to get as close to the end as possible, but probably wouldn't have gone beyond 40 weeks just in case.
Whatever decision you make, it will be the right one for you...you are clearly thinking about it and weighing up the different options...you can do no more. Good luck!

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mooma3 · 05/08/2015 09:23

Can I just ask a question please.

I have started getting very itchy feet late at night..... I read this is a sign of OC.

Should i go to the Dr or is should I be seeing other signs too?

Many thanks

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whootwhoot · 05/08/2015 16:44

Hi mooma3 - is worth mentioning to your midwife if you are concerned - I found the itch to be incessant on the soles of my feet and palms of my hands before it spread all over - you wont get a rash as it is a blood disorder rather than a skin disorder I believe. Other symptoms include very dark urine, very pale poop and in some cases you can become jaundiced however you may not have all of the symptoms, just one or two so good to bring it up and see what your midwife thinks. I'll keep my fingers crossed for you it is not OC...the itching will drive you potty.

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mooma3 · 05/08/2015 20:36

Thanks whoot - at night it drives me crazy and stops me sleeping.

Got midwife next wednesday when i will be 35 weeks - - too long to wait you think or not too much to worry about?

Thanks

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whootwhoot · 06/08/2015 08:42

Mooma - I'd give your midwife a call rather than wait...she will be able to do a quick blood test and then at least you will know one way or the other - if it is OC, the sooner they know, the sooner you can look at your options. If it is not they can rule it out and set your mind at ease. Good luck!

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Findtheoldme · 06/08/2015 08:44

I was 38 weeks when DC was born by emergency section. No time to wait for test results to come back, just had to get him born.

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mooma3 · 06/08/2015 12:02

Goodness it all sounds really scary!!
Thanks ladies will give them a call

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