obstetric cholestasis

[EthelredOnAGoodDay]

Hi

I am 38 weeks with DC2 and got called into the antenatal day unit okay because my liver function blood test, taken yesterday, had a reading of 75. I went into the day unit and had bloods retaken, monitoring of the baby (CTG?), scan and urine tests. The blood tests came back with a slightly higher reading for liver function (77) BP was up, was some protein in urine - bile acid results are due in tomorrow. Scan was fine and amniotic fluid etc all ok.
They have asked me to come back in on Friday so they can scan my liver and then look at all the results in the round to determine a course of action.
Does anyone have experience of potential outcomes for this? Even if my other results come back ok, is it likely that I will be induced because of the raised liver function test reading?

Up until now, everything has come back clear at my antenatal appts, and haven't really experienced much itching, only very mild itching on my hands and legs. I wouldn't really have even mentioned it if the community midwife hadn't been taking my bloods anyway and asked me if I'd had any itching...

Any advice would be great.

okay?! Today...

Bump

Bumping for you.

I don't have experience of this, but have a good friend who sadly lost a baby to this condition. I do not know the specifics in terms of blood test results, but if I were you, if there is any danger at all according to the medics, I would push for induction. If you are not happy with the course of action recommended, I would demand a second opinion. If there is any change at all between now and Friday in your baby's movements, please go directly to the labour ward or day assessment unit. Hopefully someone else with direct experience will be along to help.

Ps. My friend did not have much itching.

I've had it twice, some itching but not massively. i cant remember the numbers involved but 1st time picked up at 38 weeks from general bloods. Raised alt and bile amounts, not massive but hospital response was to induce at 39 weeks. Normal induction but you will likely be monitored a bit more than normal. Same second time round. They never scanned my liver or anything else. If you are happy with induction then worth going for this (I loved it!). As said before, if you feel any changes they call midwife/ delivery unit ASAP. Good luck and am sure you will be fine. Sounds like hospital are doing their job.

Thanks both. Typically tonight, I gave noticed feeling a bit more itchy. Still nothing really noticeable, but certainly a bit more than before. Hopefully on Friday then, we will agree early induction. Dd was overdue and a big baby anyway, so wouldn't be averse to an earlier and hopefully slightly smaller delivery!

Any other advice out there? Thanks!

I had this with DD2. I had been itching madly since about 30 weeks to the extent I was drawing blood I was scratching so much. My MW just told me to change my washing powder.

I finally turned to Dr Google when DH came in from work one evening and told me I looked jaundiced. Other symptoms I had were pale poo, dark wee and poor appetite. I had never heard of OC before this.

I called my MW to let her know my suspicions the next morning and she told me to go to the hospital and she would let them know to expect me.

Hospital did the blood tests and then admitted me there and then and wanted to induce me that afternoon. (I ended up waiting four days as they needed a free neonatal bed just in case). I was very closely monitored those four days with blood being tested every four hours or so and steroid injections I was induced at exactly 36 weeks. DD was absolutely fine. A horrific birth experience though with DD ending up in distress and an emergency c-section in which they even then had difficulty getting her out as somehow she had got herself wedged under my pubic bone or something.

I am in New Zealand but I imagine things are done similarly elsewhere.

Thanks again. I am nowhere near as bad as you described whowould, my itching is definitely on the mild side, and not had the pale poo, but I think my urine is a bit darker than normal. I definitely have not lost my appetite! I hope that by the hospital doing all the bloods yesterday and having me back in tomorrow, that should be sufficient info, along with the liver scan, for them to make the right decision. DH is coming with me tomorrow anyway, so hopefully between us, we will ask all the right questions.

Sounds like you are being well taken care of, in my experience I've never known anyone to have a liver scan just bloods, it's runs in my family and based on your bloods and bile reading they usually will plan to induce at 38wks unless the results are very bad and go up rapidly, you may just have it mildly but they will know the best cause of action, getting the diagnosis is the main thing, if it is though unless you go into early labour ( very common) you will likely be induced

Hi, I have had this twice now, got diagnosed at 32 weeks with dd and delivered at 33 weeks as waters broke,also had pre eclampsia, then got it in 2nd pregnancy and was induced at 37 weeks due to the oc and pre eclampsia again. Both times I had liver scans which were fine but said had to rule out the fact the results could be down to anything else. 2nd time I was monitored closely and had loads of scans, am now 25 weeks pg and been tested once but don't have it yet . I found induction fine, good luck u will be fine.

I had this in my first pregnancy (currently 25w with 2nd and hoping I don't get it again). I don't remember exactly when but probably around 36-37w I started getting a bit itchy (not palms of hands or soles of feet though). Liver function number was elevated but then a few days later it dropped. However the itching was getting worse and worse.

The annoying thing was that I had a rash and OC doesn't present with a rash, so I was dismissed as not having it, even though I did (I had two conditions simultaneously that both produced itching). During w37 I think I got about 3-4 hours sleep a night due to the horrible itching and then they finally concluded I did have OC after all and induced me at 38+1.

Induction was fine and although I really had wanted a natural birth (had planned a home birth with pool and everything) I was so desperate for the itching to stop that I would've pretty much said yes to anything. Being in hot water at that point would've been torture anyway! I ended up only needing 1 pessary and having my waters broken. Rest was all natural. They just want to monitor you a bit more often to make sure everything is OK.

The itching stopped probably about 4 days after the birth, although it's very hard to say whether the itching that drove me so insane was attributed to the OC or the pregnancy rash (although it was probably just a lethal combination. Itch + itch = mega itch).

I developed OC around week 35/36. I had itching and reduced movement. Hospital took bloods and was diagnosed next day. Booked in for liver scan and appointment with consultant before 38 weeks to induce. I was put on urso and piriton which were amazing, itching died down in a couple of days.
Doctor also said OC can sometimes bring on labour before 38 weeks. I went into labour at 37+3 and had to have a midwife with me the whole way through due to the OC and baby kept on trace the whole labour.
DS born with slight jaundice and we were kept in 2 nights as we both had increased bile levels. Luckily they dropped and we were discharged.
Good luck!!

Thanks all. I will do a little update when I've been back to the hospital tomorrow. Thanks again for your time.

Well, i went to have my liver scanned and to the antenatal clinic. Liver scan all came back clear and the stomach bile figures were very much on the low side. So am to go in again next Friday to antenatal clinic for monitoring and bloods etc, assuming that I have no noticeable deterioration in the meantime. Then if everything still is as it is now, they will let me go to my due date and then induce me. They said because my figures for liver function and the stomach bile were only slightly raised, and I am not really displaying much in the way of symptoms, on balance its better to let me get to my due date, than try to induce me early and potentially end up with a failed induction and c-section.
Thanks again everyone for your comments. They were very helpful.

That sounds like good news! Hope everything goes well for you!