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Obsteric Cholestasis?

(21 Posts)
MissPollyHadADolly19 Mon 12-Aug-19 20:24:16

Im 37+5 and for the past 4 days I've had an intense itching that only seems to happen in the evenings/night. No.rash at all.
I googled it (stupidly) and its came up with obsteric cholestasis. Has anyone had experience with this or just the intense itching? What was the procedure and outcome?

Grasspigeons Mon 12-Aug-19 20:27:23

Call your midwife. Its absolutley fine to have it but your midwife will monitor it and somtimes they decide to induce you early. I had this and being very itchy was the main sympton that signalled it although i did go off food and everything tasted metallic as it went on.

MissPollyHadADolly19 Mon 12-Aug-19 22:14:16

I've got my 38wk appointment on Thursday so I may mention it then. It's just driving me insane!
Was the itching just at night or all the time? What tests were needed?

NewMama2Be Mon 12-Aug-19 22:21:22

I mentioned this to my midwife just last week after about 10 days on intense itch only at night but she wasnt concerned as it was the tops of my hands, fingers and forearms.
They seemed to think it was mainly a concern if it was the palms of my hands and or soles of my feet, both unaffected for me.

ethelredonagoodday Mon 12-Aug-19 22:21:54

I had this with DC2. My itching wasnt particularly bad, but seemingly bad enough for them to put me on much more stringent monitoring, and to induce me on my due date.

mynameiscalypso Mon 12-Aug-19 23:42:20

I had major itching a couple of weeks ago - mainly my arms, legs and bump without any rash. I happened to have a midwife appointment so mentioned it and they immediately did some blood tests to rule out OC. They said it was unlikely and my results were all fine so it seems to just be one of those things. The consultant prescribed me a couple of creams to help with the itching and said I was fine to take piriton and it's much better now.

sorenipples Tue 13-Aug-19 07:22:35

Severe obstetric choleostasis can cause still birth in late pregnancy. Severe is now considered when bile salts are greater than 100, and is diagnosed via a blood test. They used to deliver even milder cases by 37 weeks to be safe (not sure what current protocol) .

Personally, particularly at your late gestation I would not delay in getting in touch with the midwife. I'm sure it will be fine, severe is very rare, and you can itch with much lower levels, but because of the risk its best not to take chances.

K456789 Tue 13-Aug-19 07:35:04

I was diagnosed with this at 34 weeks and had to have twice weekly blood tests to check my bile acid levels and monitoring of the baby. I was induced at 37 weeks. My understanding was they will always induce you around 37/38 weeks.

K456789 Tue 13-Aug-19 07:37:34

Just to add induction at 37/38 were the guidelines at my hospital and not to worry anyone. Once I was being monitored and on medication the itching stopped.

user1473343040 Tue 13-Aug-19 07:52:23

Itchiness (without OC) is very common in pregnancy.
With OC, the severity of the itching is NOT related to how severely you have the condition; you can have v little itching but severe OC, and vice versa.
The itching MAY be more intense at night, and MAY present on the soles of your feet and palms of your hands - but could also be in lots of other places too/instead.
Hospitals generally use a set of LFTs (Liver Function Tests) as a first diagnostic tool; if these come back anomalous they'll then test your bile acid levels, as this is the more accurate marker for OC.

OC is one of those weird conditions about which very little is known for sure. Hence I wouldn't rely on a midwife saying 'no you're fine' just because one's itching wasn't in the 'right' place.

I self-referred for blood tests towards 37 weeks. My bile acids came back at 130 (v high); I was induced at 37+4 (2.5 weeks ago); we're both fine. Birth 'cures' OC.

I found the info about OC on the British Liver Trust's website helpful, and an accurate depiction on what is actually KNOWN about this condition and its implications - ie not a lot!

I would ring your midwives and see if there's any way they can arrange for you to have bloods taken sooner than Thursday. At your gestation, they'll induce you straight away if your bile acids are over 40 (some trusts even if they're over 20). Good luck, and don't worry smile

Grasspigeons Tue 13-Aug-19 08:03:31

Dont wait until your appointment. Call today. My midwife turned up and did a blood test within an hour of me calling saying i was itchy.

MissPollyHadADolly19 Tue 13-Aug-19 19:27:23

I called the midwife today they've told me I need to go in for bloods tomorrow, I even mentioned that I had an appointment Thursday but they said it needs to be done ASAP. I never actually realised how serious it could be!
At first I thought the itching was down to the heat but the weather is much cooler now and it's still not improved. I don't understand what causes it to be so much worse at night, very odd!

The British Liver Trust website was helpful thank you @user1473343040 for recommending it smile

user1473343040 Tue 13-Aug-19 20:34:37

You're welcome, glad it was helpful, and that your midwives are On It.

SuzieQ10 Tue 13-Aug-19 20:56:18

I had it (quite severely) and was induced as soon as I turned 37 weeks as it can be dangerous. If I hadn't delivered naturally that first attempt, the consultant said it would have been a C-section situation.

My itching was intense and unbearable. The itchier I was the higher the OC (something to do with bile) was. Glad you're getting this checked out.

Sandrine1982 Wed 14-Aug-19 09:01:54

Hi all. I'm very interested in this post and in how you get on. I'm 37+4 wk today and I've had horrible itching for the past 3 months. It's worse at night and I wake up 2-3 times a night scratching till I bleed. I've been having blood test every two weeks since June but my bile acids have been within the norm (going from 2 to 3 to 7 and now I'm waiting for the last batch of results). Given the results I don't think I have OC or at least it's not been diagnosed yet. So, I'm wondering whether people get this intensely itchy skin without OC and whether they ever get to the root of the problem. Allergy to pregnancy hormones? Food? Candida overgrowth without thrush? I don't know ... sad

MissPollyHadADolly19 Wed 14-Aug-19 15:07:12

Had the bloods done today so will have the results by Monday. The MW wasnt overly concerned but then when she tested my wee sample there were traces of protein and nitrites so had to send the sample off to the lab because it's a sign of an infection somewhere. Very confused now!

user1473343040 Wed 14-Aug-19 17:07:19

When I had my first set of bloods done, they also did a urine test, which also showed some nitrites; they said it was a sign of a bog-standard urinary infection, and were going to prescribe me antibiotics (but then forgot). I had no other symptoms, so just left it at that.

The two things may (most likely?) be completely unrelated.

SuzieQ10 Wed 14-Aug-19 22:14:54

Surprised they're not giving you the results sooner. I got my results the same day, and was kept in the pregnancy Triage at the hospital until they had them.

They can't be too concerned, hopefully that's a good sign.

Hugsandpastries Wed 14-Aug-19 22:39:46

I was diagnosed with oc at about 37 weeks pregnant. I was having cold baths in the middle of the night to try to help with the itching, it felt like ants crawling over me. As if sleeping wasn’t already tricky enough when pregnant!

As others have explained above, if oc is diagnosed your midwife or consultant will recommend inducing. The contractions can be more intense when you’re induced so be prepared for that - if I was doing it again I’d probably go for the epidural earlier on. In the end I was only induced a day before my due date as the hospital was so busy they had no spare beds till then.

MissPollyHadADolly19 Thu 15-Aug-19 19:40:54

I also have no other signs of a UTI which I find strange as whenever I've had them in the past it's caused me a fair amount of pain.
I was shocked when she said I'd have to wait till Monday but when I'd gone to my routine MW appointment today the results had already come through, everything normal apparently, bile acids were level 3 and they don't see it as a concern unless it's over 10.
So another 2 weeks (or less I hope) of this crazy itching!

Hugsandpastries Thu 15-Aug-19 21:30:16

I’m pleased for you that you don’t have OC then - sorry that you have to put up with the itching a while longer though!

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