Cholestasis of pregnancy despite negative tests?

[DishSoap]

Hello all,

I went to the maternity assessment unit last week with severe itching on my hands, feet, and rest of body. I was tested for cholestasis of pregnancy and, thankfully, all tests came back with my levels on the lower end of the normal range. I'm currently 35 weeks +4.

However, this itching has not let up for one moment and it's now localised to my hands and feet. Has anyone experienced having negative tests and then gone on to have cholestasis of pregnancy regardless? Should I be asking my GP/midwife to repeat the tests in a couple of days?

I have gestational diabetes too, so I'm wondering about the implications this would have for induction (currently vaguely planned for 37-38 weeks), if anyone has been lucky enough to develop both!

Thank you

Bump!

Is the diabetes under control at the moment? As that can cause itching too. Best of luck!

Thanks for replying-- it appears to be well-managed at the moment, my levels are normalising a bit which I've heard is typical for this stage-ish of pregnancy, thank goodness

Was it definitely your bile acids that they tested?

Had you eaten beforehand? If you haven't eaten far enough in advance then it's possible to miss the diagnosis as bile acids will be artificially low. Ask them to test again, and make sure you've eaten a proper meal at least an hour before.

I was tested repeatedly towards the end of my pregnancy and once my results came back as 'no cholestatis' because it was early in the morning when they did the test and I had eaten so my bile acids were just the right side of the threshold. All the others were positive (although mild).

That said, there's not a lot they can do about it anyway.

The ICP Support Facebook group is very useful.

I had intense itching for all my pregnancies and had to really press for a liver function test for the first one, which was negative. Then when it started again with my second, my midwife said she'd had it as well and it was my body's reaction to carrying a boy.... and then my 2nd was a boy. Third one, itching didn't start until 7mths, and another boy!

Liver function is not the test for cholestatis.

My GP also ordered this when I reported symptoms of cholestatis. The maternity unit confirmed this was a mistake on the GP's part.

The test you need is bile acid levels.

if you are itching then I would go to mau/ labour triage and get repeat bloods done. You need to have them done weekly if you’re symptomatic. Itching can begin before bile acids rise.

I had this in my first pregnancy, mine didn't show up on tests until 37 weeks and I was only sent for tests after a passing comment about being itchy around the same gestation as you are now (my itching was not localised to hands and feet), when my acids got to the point of being of concern I was booked in for induction the following week at 38 weeks. I would imagine they'll monitor you regularly but if not already booked I would ask for another test.