Cholastasis of Pregnancy

[WorryW0rm]

I've just been diagnosed with ICP at 37+4 and my anxiety is now through the roof. I've fallen down many horrible google holes and have found that treatment plans in the US seem to be so different to the UK. My level is low and I'm due for a planned c section at 38+5 weeks. Everything I read from Americans says you must give birth by 37 weeks or the risk of stillbirth is really high. Wondering why views and approaches are so different? My next test is on Thursday, by which point I'll be 38 weeks. Sort of wish they could just get her out then if the risk is there... Anyone else in or been in the same boat?

My understanding is that the risk is related to your bile acid levels and LFTs. The higher your BA are, the sooner baby should be born. Do you have an appointment coming up? Can you ask the doctors to explain why they are happy for you to have your elcs at 38+5? Should hopefully give you some reassurance

Thank you for replying. Yes I think that's why they are happy to wait until then, as theyre currently low, but I'm worrying about levels fluctuating between now and Thursday without me knowing. I might see if they will give me another test before then to ease my mind a bit. I should be speaking to the doctor on Thursday too

Some of the American websites are crazy. As long as you are being monitored, outcomes for the baby are just as favourable at 38 weeks as 37. I remember looking into this when I had was pregnant.

I would beware of any support group type forums generally. They always get really hysterical and are full of fear mongering. Some people on online forums really like to lean into having an illness and make it their entire identity and practically a competition of who is the most I’ll/ who needs the most treatment etc.

I had this with both my pregnancies (the second I was diagnosed on my due date!) but first was at 32 weeks. I remember the anxiety well. But as another poster has said, please try and stay away from certain forums, especially the American ones as they are pretty scaremongering. Mumsnet is usually quite helpful though. Trust the consultants through the monitoring process. They are incredibly thorough and don't take early delivery lightly. It's all based on your bile acids, and not a one size fits all. It all sounds much scarier than the reality. Sending lots of positive vibes!

Don't forget that Americans are very litigious, especially when it comes to medical matters, so as a result the medical profession is very conservative and risk-averse. The "general guidance" you come across in the US is always conservative, and requires patients to advocate for themselves to a much greater extent than in the UK. In the UK you can generally trust that the guidance you're being given is sensible and balanced, to a much greater extent than you can in the US where it is really driven by the fear of getting sued.

Thanks all, will trust my medical team and try to stay sane until Thursday!