37 weeks and have severe itching, could it be Obstetric Cholestasis?

[chewie29]

Hi,

It's my first post so hopefully it's going in the right place. I am 37 weeks and experiencing severe itching on my tummy (around my stretch marks) and all down my legs and arms. I mentioned the itching to my midwife last week but she didn't seem concerned. Since then it has become much worse and has developed in to a rash. I saw the doctor who prescribed Cetirizine 10mg once a day which has done nothing. I have also tried numerous creams to help relieve the itching but nothing works. My main concern is that it it might be Obstetric Cholestasis, but can it be that if I am not itching on my hands and feet? Any advice would be appreciated. Thanks. x

No harm in getting it checked out, but there is no rash with OC. Sounds more like PUPPP?

dermatology.about.com/cs/pregnancy/a/puppp.htm

Thank you, that does sound just like what I have got. x

:) hope you can get some relief. I had OC, and know how awful itching can be, whatever the cause!

Hi! Not sure if you usually get a rash with OC? Do you? Could it be some kind of viral infection or a reaction to changing hormones?
I'm currently 35wks preg with my 4th and had extreme itching during part of my last pregnancy and also this one. This time (touch wood,) it was only severe at about 25wks and lasted about a week, (just before I thought I'd have to get it checked out it subsided :)) I'm itchy now, (particularly bump,) though is nothing compared to what it was! (Felt a bit like prickly heat without the heat before, like needles attacking every inch of me!) Not sure if it was liver related but I did notice it was worse at times of constipation!?..(If that could be a link?!)
If in doubt I'd get checked but think it could just be a reaction to your changing hormones as you approach labour??

In my experience, there's no rash when you have OC, you itch mainly on your hands and feet and is normally worse at night.

If you're worried, ask your midwife to do a blood test to check your bile levels.

vvv itchy here, tho I've found piriton helpful. You'd have to stop the certazine while trying it (both anithistamines) but you can get it over the counter. Eurax helps a bit now and again but it is so maddening that can't help scratching it when it's bad . DH winces when he sees it, whih he does quite often as it's less itchy when uncovered (waiting for the day all too soon when I scare the postman with it ) Also much worse at night due to being warm.

I'm waiting for blood tests to rule out OC - mw here said they do them as routine for itch even if unlikely to be OC, so def pester mw or GP for them (LFTs and bile salts I think).

There's a thread on childbirth too with lots of people's helpful suggestions - oatmeal bath and pine tar soap?

I had a brilliant cream for my itching, it's called Arjun. It is 2% menthol in aqueous cream.
You can get the same effect by mixing vick into E45 or similar and keep it in the fridge.

Beware of getting into th OC trap, I ended up being monitored three times a week and having weekly bloods to check for OC from 30 weeks until I gave birth at 38 weeks even though everyone was convinced I didn't have it.
The lack of staffing meant the consultants were in demand so would only see you if the levels rose but they were the only ones who could sign you off the monitor/bloods treatment.

Thank you for all of your responses. I went to the doctors again yesterday and he prescribed me Betnovate cream, i'm hoping it will work. My midwife also got back to me this morning and she said that if the cream doesn't resolve the itching to go to Maternity Triage for a blood test. Hopefully it will improve today, last night I could have scratched my legs off, the are red raw now! It does would more like PUPPP than OC but I will get it checked out if no improvement, can't take any risks with the little one. Thanks again everyone. x

I had two bouts of different itching with DS1. One was thought to be hormonal, on legs and arms, mostly around joints, you could see red slightly dry patches after I'd been scratching. The doc prescribed piriton and it did the trick. I think it may cause a sleepy baby if taken near birth but it was worth it. Second was PEP or PUPPP depending on US or UK title. It showed as tiny little bumps inside my stretch marks on my tummy. The itch was vicious, compulsive, brought me to tears. For that they gave me a steroid cream, and again it was worth it. Only thing I'd say is the steroid cream dries your skin a bit and seemed to make my stretch marks worse. In both cases being warm was worse, in bed at night for instance. Cold showers seemed to ease it or an ice pack. Over the counter stuff wont work for PEP, you can use all the calamine lotion or anything else you like and its going nowhere, it also may take days to a week or two to clear post-birth so if you're holding on for D-Day for relief you may want to get the prescription on hand just in case!

Also, your midwife should have been far more interested in the itchiness as it can (on hands and feet) be a sign of pre-eclampsia. Also can be a sign of cholestasis (they tested me for that). But best best is its hormonal and therefore treated as allergy related, or PEP.

Hope that helps. Its a horrible thing to have I remember. It doesnt usually happen in subsequent pregnancies, I never got it with my 2nd and now pregnant with 3rd its not showing either. PEP seems random and they dont know what causes it.