itchy skin

[Shayla1]

I've been experiencing really intense itching all over my body for approximately 1 1/2 weeks, Ihave no rash and my urine is so dark it's almost black. Saw a nurse on Monday who took a liver function blood test to rule out the possibility of obstetric cholestasis. The blood test come back that I have glandular fever? despite having no symtoms. I'm really worried that I have this liver condition and the results that have come back in the blood tests have been misinturpreted. In was wondering if anyone had experienced the same sort of thing. I have an appiontment with a doctor this afternoon would anyone think it would be unreasonable if I asked for the blood test to be repeated?

[Twiglett]

You are entitled to ask for a second opinion so I would do it if there was any doubt in my mind

(sorry don't know about intepreting tests)

[Prufrock]

LFT's are not the definitive test for OC. How many weeks are you? You should ask for a Bile Acid test to be done (expect to wait 7 days for results) which will tell you if you have OC, although IME the itching can begin way before the bile acids or LFT's show elevated levels.

Do you know what the AST and ALT levels were on your LFT's - these are the ones that can indicate OC

[Shayla1]

Hi Prufrock.
I'm only 16 weeks pregnant which is why the nurse was statisfied with the result coming back as glandular fever she explained that OC was unheard of before 26 weeks. I've seen a doctor today who was a lot more help. He explained that the reason I was told I had glandular fever was because the levels in my LFT were raised only slightly (he didn't mention AST or ALT)and in someone who wasn't pregnant the level would be interpreted as Glandular fever. He's requested that more advanced blood tests be carried out on Monday. He also spoke to the obstetrition at our local hospital who has requested to see me apparently for the rest of my pregnancy as he thinks if the LFT levels are raised already that even if OC isn't present yet it will show at some point. this is my second pregnancy and I never had anything like this before. I feel more relieved now someone is listening to me and hopefully monitoring me and the baby closely.

Sorry if I've babbbled

[Shayla1]

Does anone have any tips on how to help the itching after my eighth sleepless night in a row I'm at my wits end. At the moment I'm covering myself in calamine lotion and using E45 itch relief cream the effects of which last for appox 15 mins after application. I went through a whole bottle of calamine lotion last night! and had three baths.

[Prufrock]

Shayla - I'm listening as well.
I do know what you are going through - my itching started at 13 weeks second time around, and I definately had OC so tell your nurse to come speak to me.

My presentation of OC was the less common one though - intense itching early on, slightly elevated AST and ALT, which went sky high by about 18 weeks, but still no raise in Bile Acids. Then at 33 weeks (a more usual time for OC to start) my bile acids did what they are meant to and went sky high as well. Fortunately as this was my second time of having OC the health proffessionals were prepeared to believe me when I said I itched at 13 weeks. The good news is that it's thought to be the high bile acids that actually cause the danger to the baby, so your "only" problem at this stage is the itching.
The standard drug fro OC is ursodeoxycholic acid, and I found this did relieve my itching somewhat. It would not normally be given this early (simply because they think you can't possily have OC yet) but my consultantwas happy to start it as soon as my LFT's were elevated, and gave me a far higher dose by the end (I used up the entire stocks in the hospital pharmacy)

TO stop the itching, give up on the calamine - it doesn't help. Keep cool, cotton/linen clothes, a fan. Body shop peppermint cooling leg gel can work, but not if you've scratched teh skin so it's irritated. You can also ask your doctor to prescribe a basic diprobase skin cream with menthol added - it helps to cool the skin. I also saw an excellent homeopath who prescribed me various remedies to help strengthen my liver. NOt sure which of the above worked for em, but I did itch less second time around.

If you have a spare few hours, I , and others have posted extensively on this in the past - Do and archive search on my name and OC and you'll get the majority of the posts about it.

Which hospital are you at?

[emeraldefmach]

Totally agree with prufrock. I had OC in all three of my pregnancie and the itching started earlier each time. Hideous, hideous, hideous...


Prufrock, I had the opportunity to talk to Jenny
at great length in my 3rd pregnancy and she was really fab and helpful. What an inspirational woman.

[Prufrock]

Isn't she - truly an example of something wonderful coming out of something terrible.

(Shayla - Jenny Chambers runs the OC advice line - 0121 353 0699). Her story is on page 7 here

[jabberwocky]

Shayla1, does your skin seem dry at all? That can make the itching worse and the baths would increase the dryness. I used a lot of massage oil as lotion just wasn't enough. Bath and Body works lavender vanilla oil is lovely.

[donnie]

I am very moved by that story. I do not have OC but have suffered with bad itching and had to be tested for it. All I can say is pester and pester until you get somewhere ( although it sounds like you are being taken seriously not shayla).Also I find Aveeno cream is very good, also the Boots pregnancy wonder balm which is in small tubes and part of their mediterranean range.Good luck.

[kelli22]

I didnt have OC but during my 1st pregnancy i itched from neck to ankle for the last 7mths and im now on my 2nd pregnancy and its not been anywhere near as severe - first time it was something to do with my hormones as it disapeared 1 week after my dd was born. this time its just my legs, mainly at night - the doctor gave me some antihistamine tablets for the itching and they seem to do the trick.
hopr you get some relief soon and at least theyre listening - the doctors kept telling me i had scabies- which i didnt!! i got treated for that quite a few times with no effect - obviously as that wasn't the problem in the first place but i saw consultants and dermatologists and everything
they even moved me from the ward and treated me again the day after my dd was born.

[Shayla1]

thanx for all the tips.
I went to the pharmacist yesterday. Was actually banging on the door when they opened at 9am. He said he'd had a lady in the past who had OC and was told by an doctor she could take piriton syrup in the smallest dose. I'm a bit warry as the doctors themselves never mentioned it to me but used it last night and it was magic actually slept approx 6 1/2 hrs before the itching woke me up again i'm trying not to use the syrup during the day and keep it only for night time relief when the itching's worse and will check with a doctor that it's ok. I will use some of the tips that you've posted here for daytime relief but it's so surprising how much better a nights sleep
can make you feel.
Prufrock thanx for the advice and info went back through some of the old stuff and found it useful I've also contacted Jenny. I live in Cornwall so am currently under the Royal Cornwall Hospital Trelikse.

[Prufrock]

Shayla

Piriton is safe for use in pregnancy, but if it is OC it will not help with the itching - different chemistry. So you might have something else. Or it probably helped you to sleep because of the slightly sedative effect it has.

[CrazyDi]

I had really intense itching at about 26 weeks and i got tested for liver function, but came back ok and after a couple of weeks it did calm down. I actually narrowed it down to the fact we moved home and my new house had a shower, so i used that more than the bath and thats when it calmed itself...I have my baths really really hot and apparantley thats would could have caused mine..but during that time it was horrible and sometimes i used to be close to going mad as i couldnt stop the itching! I got prescribed piriton and thought they were great...dont know if they stopped the itching but i got some sleep at least as they knocked me out!!

[cori]

Is the Itching associated with OC an always all over the body or can it be localised.?
I am 15 weeks pregnant, I have had localised itching on my Shins since the begining of this pregnancy. I have no rash as such but it does caused raised bumps. My Urine is also quite dark.
Any ideas?

[Shayla1]

Cori the itching I experience Is all over it started with my hands and feet and grandually spread up my arms and legs until it was everywhere. The only place it isn't too bad is on my slight bump itself (I don't know what is normal or not.) Have you had your itching checked did anyone mention OC?

[NannyJo]

I had OC in my pregnancy. At 32wweks my itching got bad and midwife arranged blood test at docs. I rang back for results and was told all normal. itching continued. It was so bad i was making my skin bleed all over so i rang midwife and got told to go to hospital. They took further tests and told me AST's were high, could be OC but need to test bile acids to confirm. They too were high but not worryingly yet. I was still told to prepare for prem baby, had steroids to strengthen baby's lungs.
Iwas in daily being monitored and scanned. AST's taken and had raised dramatically. Consultant would not allow further bile acids to be tested 'budget wouldn't allow it!!!'
The midwife had to fight to get him to change his mind for a day or two. Eventually he agreed. Results from that were worrying and i was told they would deliver baby immediatley.
DS (now 6months) arrived 5 weeks early, all well thank god.
Not only had the doctors surgery wrongly read a life threatingly blood test result but i dread to think what i would have done to the consultant if he hadn't changed his mind cos my baby may not have been with us today.
It was a horrible time and i'm sure it is rare the way we were treated but i would say to anyone with itching to get tested cos it's better to be safer then sorry!!!
However i would do it all again tommorrow but DH is very wary about further children. I know that i 100% want to experience the whole experience again.
Can anyone who has had oc on more then 1 occasion please give me any advice, tipsor help. I would greatly appreciate it.
What professional guidance is there? Are you monitored closely from day1 etc??
Thankyou, sorry about essay!

[cori]

No I havent had it checked , as I havent had an appointment with MW yet. I have my booking in appointment next week. Will mention it then.
I feel the localised itching is unusual as I have not had it before. Nobody has mentioned OC before, I only found out about it whilst trying to discover whether my itching was a normal pregnancy symptom.

[NannyJo]

if you want cori you can call midwife line tommorrw am and they would do the test for you if that will put your mind at rest.

[Prufrock]

Cori - do ask for a test, though tbh just shins doesn't sound like OC - the itching is because the toxins that your liver would normally get rid of are still in your blood, and they escape through the skin, in places where blood flow is near to the skin - hence hands/feet. And at 15 weeks OC is no danger to yoru baby, so please don't start getting worried.

NannyJo - I've done OC twice. After getting less than optimal care the first time around I made sure I managed my care properly next time. At my booking in appointemnt with the midwife I told her that I had had OC, and insisted on LFT's at every appointment (6 weekly). Once they were elevated (about 16 weeks), I was referred to the hospital (A brilliant Maternal-Foetal Assesment Unit) and seen by a consultant (my wonderful midwife at MFAU "accidentally" transferred me to the best in the hospital). I was put onto high-dose urso very early on, given twice weekly scans (growth/umbilical doppler and ductous venousis) by my consultant and weekly LFT's and Bile Acids by the midwife. I had private medical insurance, which I used to have a very luxurious c-section, performed by the same consulatant but in his private practice, and saw him twice privately in advance of that, but he advised me to stay in NHS up to 36 weeks as if anything had gone wrong he was better able to treat me in a big teaching hospital. I also wrote a brief summary of my first pregnancy, my second pregnancy so far and what I wanted from my second so that any new doctors who saw me would recognise that I knew what I was talking about. I do think that I managed to have a very succesful an controlled second time around experience of OC, and that was because I took control myself.

[cori]

Thanks, I am not overly worried now. I am only 15 weeks. Everybody elses experience seems to suggest the itching is wide spread.
I will mention it at my booking in appointment though.

[Shayla1]

My own midwife has been in touch with me today she said that she has only ever seen one case of OC and that she wasn't managing that case herself. She said that because the consultant is pretty sure I have OC she is trying to get some more info for herself she's contacted other health professionals for advice and also said to me to see what I could find so we can share info together. Was just wandering if anyone knew if there was a general internet info sight or leaflets etc that I can send off for?

didn't manage to sleep as well last night I think the piriton is only making me drousy i was still itching like mad but half asleep with it! Had blood tests today and c consultant Wednesday so hopefully the results will be back and He'll be able to give me something

[Prufrock]

This is some fairly basic info. (Note that benefits of dexamethasone for the itching have been disproved by more recent research, though it is still useful to mature the babies lungs if very early delivery is expected)

This is the most useful stuff for best practice management. It does recommend frequent CTG monitoring, which IMO (but I'm not a health professional) is not necessary - it can only tell you that your baby is OK whilst you are hooked up to the machine and has no predictive ability. Of course, it's nice to have that reassurance, but it is a bit of a waste of your time. My consultant also recommended's doppler scans of the baby's heart (ductous venousis) which is a fairly new thing they can do, hence it's not in the literature yet.

[Shayla1]

Prufrock
Thankyou so much for the info you have given me I have found you the most useful source so far! I really appreciate the time you have taken to help me. Jenny contacted me today she seems like a lovely person too ready with all sorts of help and advice. Hopefully I can get myself as informed and aware as possible so that I can also help reduce the risk to my baby.
Prufrock you mention that your second baby was delived by an elective cessarian, do you have to have a c- section if you have OC or can they induce you so can have a vaginal delivery? I know the risk of maternal hemorrage is greater do you know which method they recommend for the lowest risk of this happening?

[Prufrock]

You don't have to ave a c-section at all. You can be induced, but you should be aware that if you go for an induction at 37-38 weeks there is a relatively high chance of having to have a c-section anyway as your body may not be ready to deliver yet. I was induced first time round but after 36 hours I still hadn't dilated, so went for a c-section. That meant that 2nd time round (for me) it was better to have a c-section again. That isn't to say that it's not worth trying for an induced natural delivery - just be aware you might need to go to Plan B.

Teh bleeding thing isn't really an issue as it can be easily controlled - they will monitor your clotting levels in your blood closely, and give you Vitamin K if they get too low. So in a properly managed case excess bleeding doesn't happen.

[Shayla1]

I saw the consultant on Wednesday he had my lft's from monday which were still high. I also had bile salts taken on Monday but they said it would be 1-2 weeks before the results are back. The consultant said he was 95% sure I am a typical case of OC but he has to wait until the bile salts are back to make a complete diagnosis. he wouldn't give me Urso until then. He's also requested a scan of my liver and an additional ultra sound of the baby at 24 weeks. I've got another appointment to see him in 4 weeks in the meantime I'm seeing my own midwife reguarly and continuing to have weekly blood tests. He said that when the bile salts come back if they are high (which apparently they aren't always this early on) he will then prescribe urso. I feel a bit more reassured but thought he could wave a magic wand and give me something to stop the itching I've had so little sleep I'm starting to look like a zombie!