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Cholestasis - just been diagnosed and need advice and reassurance pls!

(14 Posts)
kookiegoddess Fri 29-Aug-08 09:54:08

Lots to ask here, sorry it's long. I'm 34+5 wks, I've had itching and test 3 days ago showed ALTs at 363. Am awaiting results of further tests to rule out any other liver function problems and have a liver scan on monday.

I had been planning a Homebirth and it now looks like I may be induced at 37 weeks (doc has said it's "likely" in my notes).

Induction is obviously the very opposite of what I'd been hoping for so does anyone have advice on how to cope with induction, anything natural I can do to help myself, what to ask for in hospital so that I can maximise natural movement and birthing positions (re: monitoring etc). I'm quite anxious about being forced to have drugs I don't want and/or being rushed into taking them if I'm not clear about what's going on.
Also what to put in a birthplan for induction??

Also, at what point did your docs decide that you needed to be induced? If they don't induce me, would I be able to have a HB and proceed as normal or does the possiblity of Cholestasis rule me out for HB?

Also, Bilirubin level is 10, what does this mean?

Did you make any changes to yr diet re: low fat, low saturated fat? I drink A LOT of milk and don't think I'd manage to cut that out really. Do diet changes impact yr levels? I've just read something which makes it seem that it doesn't really help but that's the danger of googling...

Did any of you decide to let yr baby go to full term given the outcomes of studies of Cholestasis are unclear re: stillbirth? How did it go for you?

Also is it worth getting a 2nd opinion? I'm london based, my hospital is St George's. I'd be happy to pay/travel to get an opinion from an expert if it's worth it.

I'd really appreciate any advice you might have. Just any help with getting my head around the swing from HB to induction would be a start!

TIA from anxious kookie.

Aubergenie Fri 29-Aug-08 10:46:09

Hi Kookie, Sorry you're going through this. I'm being monitored for the possibility of obs cholestasis at the moment as my ALT levels are raised (around 80 at the moment) and although it's not been definitely diagnosed I've been having many of the same thoughts as you. From what I gather so far, even if things continue unchanged and my ALT levels don't go up, I would be not be allowed to have my baby even at the midwife led unit at the local hospital so, unless their criteria are very different, I think they would be unlikely to allow you to have a home birth.

I asked them at the hospital whether there was anything I could do, e.g. dietary changes etc and they said no. I'd be curious to know whether anyone has any alternative suggestions.

Like you, I've been worrying about the prospect of induction so I'll be watching this post closely. I was originally hoping for a home birth too, so I know what you mean about having to get your head around the change!

LeonieD Fri 29-Aug-08 10:48:05

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kookiegoddess Fri 29-Aug-08 10:51:33

Have you been offered Urso/Vit K? I haven't been offered anything but my brain went to mush once the doc told me I'd prob have to be induced so all rational questions went out of my mind. She basically said there was nothing I could do. I asked straight out "so I've no choice but to be induced?" and she said "there is always a choice, let's see what yr results are etc" so hope they will be amenable to discussion...

Quite tough to deal with tho. Am looking at induction threads at the mo...sad

kookiegoddess Fri 29-Aug-08 10:52:46

Leonie do you know what the acronym is for bile acids? I have 4 diff numbers in my notes but not sure what they refer to, except the ALTs.

Aubergenie Fri 29-Aug-08 11:04:20

I've just looked at my notes and it just says "serum bile acids". I haven't been offered any treatment yet as I don't have a firm diagnosis. I'm asymptomatic, so they're just monitoring me very closely and taking bloods twice a week and I've got a liver scan booked.

I looked at some induction threads too and had to stop as it was freaking me out a bit...

Aubergenie Fri 29-Aug-08 12:07:00

I should add that they did say to me that they would offer me medication (didn't say what exactly) if it did develop.

Iknow they said I can't do anything about it, but I read somewhere that lemon in hot water was good for cleansing the liver, so I've started drinking loads of that and I've dusted down my juicer from the back of the cupboard and started making fruit and vegetable juices, and eating lots of raw veg. I figured it can't do me any harm anyway and it feels at least like I'm doing something...

LeonieD Fri 29-Aug-08 12:35:55

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ElfOnTheTopShelf Fri 29-Aug-08 12:39:34

My friend had this in her third pregnancy. at the time the baby was also showing breech, and the hospital were refusing to turn the baby so it was looking like she'd have to have a section.
Luckily the baby turned, so she was incdued rather than sectioned, and she had a very "nice" labour (her words!). She had one start naturally, a section and the third was an induced VBAC and she said it was nice.
I can get her to post maybe?

kookiegoddess Fri 29-Aug-08 13:39:39

Elf, great if you cd get yr friend to post, any advice or experience would be fantastic. THANKS!

ElfOnTheTopShelf Fri 29-Aug-08 17:39:17

I'm out for a drink with her tonight so I will ask for some details and paraphrase in the morning

LiegeAndLief Fri 29-Aug-08 20:39:35

You might want to do a bit of research around the induction thing - there is some evidence that OC is linked to higher risk of stillbirth after 37 weeks, however as it is common practice to induce at 37 weeks the risk of stillbirth has only been linked to undiagnosed OC. There is pretty much no research (as far as I know) about actively managed OC past 37 weeks. Sounds like you may already know this from your OP... Anyway I think it is definitely worth getting a second opinion as some consultants do not automatically induce at 37 weeks but will let the pregnancy proceed whilst being actively managed. I think you'd be lucky to get anyone to consider you low risk for hb though sadly.

Really sorry about this, hope the itching isn't too bad. I had OC but can't really offer any advice or reassurance as I had severe pre-eclampsia as well and needed cs at 34 weeks (for PE not OC). Good luck!

ElfOnTheTopShelf Sat 30-Aug-08 14:46:10

I did speak to my friend, and she said that she had a very well managed and good birth with her third, despite being induced she still felt in control.

kookiegoddess Mon 01-Sep-08 21:33:39

Thanks elf. Just trying to sit tight and wait till I see doc on Thurs to find out more about what will happen. Itching away till then...grrrr

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