Obstetric cholestasis - 2nd pregnancy

[susanita]

I?m 32 weeks pregnant with 2nd baby. I was diagnosed with Obstetric Cholestasis right towards the end of my 1st pregnany. I hadn?t started itching until about 37 weeks and, despite going to the hospital 2-3 times after talking with midwives, the doctors at the hospital felt that I couldn?t develop OC so late. It was only after seeing a midwife for a routine appointment who, after seeing me scratch myself furiously, referred me to another midwife who liaises with consultants dealing with OC that I was told that doctors had overlooked abnormal blood results and I had to be induced that day as it was dangerous for the baby ? I was 2 days over the due date.

I am being monitored by consultants this time and having blood taken once a month. I?ve been given guidelines as to what I should do the moment the itching starts. I know that the same oversight cannot happen again but I?m feeling really very anxious now. At what point did other mothers start itching and when were you induced? How did you cope with the itching? I just remember that incredible itch that wouldn?t let me sleep, scratching myself until I bled and I?m not looking forward to the high probability that it will happen again. I?m also not looking forward to being induced again although I guess that not having some of the surprise/shock of the first time around will hopefully mean I won?t be so stressed. I guess I?m still mad that I just knew something was wrong, kept seeing doctors and then being told that results were overlooked and I had to be induced immediately to save my baby?s life.
Sorry to ramble on, I?m just a little scared now I?ve reached the final stages.

Agree that its probably not OC this early on, but get it checked for your peace of mind. FWIW in both pregnancies I got VERY bad eczema almost the moment I conceived.

The doctor thinks its a reaction to pregnancy hormones. Is this possible? Does this mean I have abnormally high levels? Some foods seem to make me worse - tomatoes in particular, and possibly sugar, but again, I've never had this before. Is it possible to suddenly develop a sensitivity to foods in pregnancy? The itching and rash get worse in the evening and first thing in the morning, but seem to improve during the day.

Anything can happen with pregnancy hormones! If it were OC then what you eat wouldn' affects it, and the itching would be bad ALL the time. Probably is pregnancy hormones. Doesn't mean you have abnormally high levels, just that you are sensitive to the hormones, I mean some women get morning sickness, some don't.

Watch what you eat for a week, see if it helps. It may get better as you get further on in your pregnancy.

Sorry if you've said this elsewhere, but is this your first pregnancy?

scuse typos am b/f

Thanks pie - this is my second pregnancy. Perhaps the problem is that I expect it to be trouble-free, like the last one was (no morning sickness or anything - I sailed through it). I've just been to the doctor's again, who has said if it's no better by Monday to go back and they'll take bloods. She recommended Piriton, but the pharmacist advised against it. I am really reluctant to take anything at all, so guess I'll just have to itch and put up with it!

Go back and see your doctor for your own peace of mind.

I know what you mean about expecting it to be the same, loved being pregnant the first time, it put me in a wheelchair and hospital the second!

Stringbean - loads and loads of sympathy from here. I too had dreadful, hideous, horrid, painful, irritating itching for most of my second pregnancy. It wasn't OC - was tested for it. The GP helpfully told me there was nothing he could suggest, but that it would disappear within hours of giving birth ... it did! I did find the calamine cream (not the lotion) offered a little relief for short periods, if I really smeared it on. The only other thing that helped was long, tepid baths.

Sorry - hope this isn't too depressing for you.

The good news is I didn't get it again for my third pregnancy - so it isn't inevitable.

Had typed v. long reassuring message but dd deleted it.
In summary- def not OC- yours is classic allergy symptoms, OC is non functioning liver so excess toxins.
Discuss piriton with doc again - it's one of those drugs that isn't safe in pregnancy because theres never been proper clinical trials, but is prescribed when benefits outweigh risks because there haven't been any reported problems either

Thank you all for your messages. The rash has subsided a lot over the morning (but I've been outside in the cold, which helps a lot). Just had something to eat, so I'll wait and see what happens. I'm keeping a food/rash diary to see if I can identify any triggers. Roisin, so sorry to hear you had to put up with this for most of your pregnancy, but so relieved to hear I'm not alone. Was beginning to think I had some weird unidentifiable disease, so it's good to know someone else has been there. The thought of frantic irritating itching for the next 30 weeks is not a pleasant one though. The doctor said she thought it would subside after 12 weeks, so fingers crossed.

Thanks for your advice about Piriton, Prufrock. I'm so reluctant to take anything - I wouldn't even be happy taking paracetamol (even though I know it's OK), and am inclined to agree that this is an allergic reaction. Can pregnancy trigger this?

hi,
i'm in my 38th week and i'm due in 2 weeks.i developed itching frm last week...doc thinks it Cholestasis and gave my blood for test...that'll take another week.i'm worried since i have heard that if i have OC i shud be induced by 38th week.my doc started with URSO.does it really help?or still shud i be induced in 38th week? my doc didn't say anythg abt inducing so far...wat he told was it has nothing to do with the baby...and URSO is to relieve frm itching.
wat shud i do?

Hi thankuss.
I don't want to worry you - but in your situation I would go to hospital tomorrow.

Why does your doc think it may be OC? Where are you itching? Do you have any sort of rash? Has he done LFT's or a bile acid test? If it's LFT's (which are not definitive) the results can be available in 3 hours if it is an urgent request. The definitive bile acid test does take a week to process. Are you booked in to give birth at a hospital - many have a policy of admitting women presenting with suspected OC after 37 weeks.

You are right to think that OC can be dangerous for the baby after 38 weeks - in non-managed cases there is a high (up to 20% in some studies) risk of stillbirth. This gets worse the longer you leave it.
The Urso can help. Both with the itching, and it helps to lower the bile acids which are building up (latest research suggests that it could be the high bile acids that cause sluggish foetal blood flow and therefore stillbirth)

The main thing to remember though is taht many women with OC DO go on to have succesful pregnancies - I've had 2 myself. And if you are feeling your baby move then it is OK. Go to hospital immediately though if you feel any major change in the pattern of movements.

I'll be here for another hour or so if you have any specific questions - for more general stuff try a search on OC with me as the author under archived messages. I reckon I've posted on every thread we've had on this subject

i had oc with my first child. i got it when i was about 5/6 months pregnant. it covered the whole of my bump( and it actually looked like a burn) dr's put it down to " the heat", which i knew it wasnt . then i was told it was just a "slight " irritation!
in the last two weeks of pregnancy the itching was horrendous, and i got referred to a consultant, who sai " we wont induce you, as its only on your tummy". but it wasnt, it had spread all over my back! and when he saw this he booked me straight in to be induce.
it wasnt untill after the birth i found out i had oc, and how dangerous it was!

sassybabee -if you actually had a rash it is quite unlikely to be OC. It may have been PUPP instead, which tends to be worse for you, but not as dangerous for your baby.

I had one of the WORST cases of OC. I wish I had started itching so late! I started itching at 19 weeks and was induced 34 weeks! It was the worst experience of my life. I'm currently 14 weeks in my 2nd pregnancy and praying to the universe if OC is my future to please big it on later.