Obstetric cholestasis - advice and reassurance needed

[Babygirlpw]

Hi. I am 26 weeks, and have for the first time had some serious itching. I had heard about obstetric cholestasis, so had the blood test. Midwife phoned today to say my results weren't in the normal range, and I'm off to see the doctor tomorrow.

Just wondered if anyone has had this? And what their experience has been. I'm so scared as I read some stuff in Google about stillbirth risks.

I was told very early on I may have this as my liver counts were a bit shot. So I did a fair bit of reading. From what I read (and I read a lot), the risk of stillbirth is very low and in fact some say there is no evidence to say the risk increases at all, especially if caught, monitored and treated. The biggest risk is having prem babies as you become so uncomfortable and need to be induced or ELCS. So try not to Google yourself into a frenzy. Dr Google can be a right bitch sometimes.

I had some more tests and my liver started to behave and actually turned out I don't have it so I can't offer any words of wisdom but didn't want to read and leave. If they have caught it early they should be able to monitor you and the baby closely and maybe try and relieve some of the itching. Hope you feel better real soon - whatever the cause may be.

I met someone with this condition who said the British Liver Trust were useful. Just to reassure you she had a healthy baby but the condition was not widely known about in the uk, at least 11 yrs ago at any rate.

Hi me my mum and sister have all had it, there is alot of talk about the possibility of stillbirths etc but not alot of evidence as generally it is if you went full term and if you have it, because of the risks you would almost certainly be induced,
it is rare but can run in family's like mine obviously, we all reacted differently, my mum as horrendously Ill very early although back then they didn't know what it was and we were all early anyway 37wks so still full term, my sis was very ill and has been induced twice at 38 and 37wks and I was fine apart from some itching and dd came with no warning at 37wks, all fine and healthy although they've all been a little jaundiced, they will take good care of you if you have it and you would have probably weekly scans and bloods to check everything is progressing but seriously don't bother googling anymore, I found little information that could help but feel free to ask any questions we have had just about every variation between us

Thanks guys.

Kittykatsforever - did you all discover it early on? Do you know if that makes a difference? The itching isn't horrendous every night, in fact so far I have only had one bad night.

I had tests from 28 wks I think but neg til I actually had dd ( had the test the day before ) but just had itching and mine never went bad really, by sis was neg til 35 even though she had feeling really sick etc, I dont think it particularly makes a difference, my mw knew someone who had tested pos at 12wks just that unfortunatly you will possibly get to feel worse, in every case I know baby has been fine it's the mums who suffer as it were, if you do get a positive though they will probably give you vit k and medicine, I never had any, another strange thing is oc labours tend to be very quick and erratic contractions so the only thing I'd remember later is get someone to examine you as they wanted to send me home as I wasn't in proper labour aparently until my mum insisted! My sis had beautiful dd last wk and from when they broke her waters dd was born within 50 mins after! ( that was dc2 though)

I had this with DS. OC is diagnosed by two tests, increased liver function tests and raised bile acids. They should test for both. If it's just increased lft's they'll do other tests to check for alternative causes, I had a complete viral workup and a liver scan to check for gallstones. They'll carry on testing for bile acids for the rest of pregnancy.

If your bile acids are elevated they'll prescribe vitamin k and ursodeoxycholic acid, the urso works to neutralise the bile acids. The bile acids are what could be dangerous to baby and what make you itch. The evidence for this is a bit sketchy as they had a trial in Australia and one of the babies in the control group (mother had untreated OC) was stillborn so they ended the trial but the data can be interpreted multiple ways from no increased risk to a doubling of risk .

I think the risks are minimal if it's diagnosed, I had lots of extra monitoring and if they think there's any danger they'll induce early. Monitoring was done at hospital rather than by midwife, I didn't see my named midwife again till post natal visit. Be prepared for spending a fair bit of time in hospital waiting to see consultant or for monitoring if they're very busy etc. I found out where the local costa concession was in hospital and used to leave mobile number with receptionist and ask her to call when they wanted me to come back.

I had raised lft's from 28 weeks so was told I probably had it but bile acids didn't shoot up till 38 weeks. Being diagnosed early is a good thing as you'll be given extra special care.

I'd second what kitty said about erratic and fast labour. Which no one mentioned to me atall. Midwife did say to DH when we arrived at labour ward. It threw me as everyone suggests you'll be in labour with your first for ages and not to go to hospital too soon. I managed a measly hour and a half at home before I went into demand drugs!

Thank you for all your advice.

I have slightly raised ALTs, my bile acid is fine. I have the liver scan and more blood tests being done. She said she doesn't think it's obstetric cholestasis, but I'd all the other tests come back OK, she's going to start treating me for OC.

I think I've calmed down, as I know that provided I'm monitored, baby will be fine. Fingers crossed there's nothing wrong, and my slightly raised ALT is nothing more than that!