obstetric Cholestasis OC/ICP

[Superscientist]

I'm just looking for others experience of OC/ICP.

I've just been diagnosed, my levels are currently in the "moderate" category so they are looking at induction around 38 weeks and I'm on weekly bloods to monitor my bile acid levels. I'm hoping they stay stable or drop. What did others levels do?

Also any tips for the itching? I can't take antihistamines which is annoying!

Sorry to hear this OP. I am a midwife and see OC often.

If your levels get higher they may offer ursodeoxycholic acid which can help. It’s a shame you can’t take chlorphenamine.

How many weeks are you?

Hi I had it in three pregnancies and was on weekly blood monitoring, mine stayed quite high. My daughter was induced at 38 weeks, my son came himself at 36 weeks and in my last my levels weren’t as high and she came about 6 days early

I had it. I was told I would have bloods at least weekly and be induced at 36 weeks. In the end I didn’t get past 34 weeks. Sorry I can’t suggest anything for the itching. It was more my feet than hands. Would just try and keep them cool which helped.

I had this, with high levels. The first set of drugs didn’t do anything, they came down slightly with a bigger dose, but was induced at 37 weeks. I had to go in for monitoring at MAFU twice a week as soon as it was diagnosed at 32 weeks.

All was fine. The itching was insane, though. Was a heatwave for me, so cool baths were my saviour.

Thanks @ForLoveNotMoney they discussed UDCA with me but said the hospital no longer prescribes it.
Another medication I'm on is a sedating antihistamine so I can't take two but I'm still awake half the night itching. I've been on this medication over 10 years and I'm not sure it has a sedating effect on me anymore but they can't risk the compounding effect of being on both. In the early days of being on the medication antihistamines had a problematic level of sedation on me as in sleeping for 16h within half an hour of taking them which with a 5yo might not be ideal!

I'm hoping to go to my in-laws for a couple of weeks at the end of August for a break and child care. They have said if my levels are stable I'll be able to go but maybe not if they are increasing so that's the immediate goal!

Thanks @Benshawsberries were they stable but quite high or actively increasing? My daughter made her own arrival at 38 and a bit weeks so maybe this fella will do the same

Thanks @KiwiFall and @OnlyMabelInTheBuilding

The itching starts with my hands and feet but spreads everywhere under my bra strap is an inconvenient place when in public!

I get a reprieve in the afternoons but it's fairly constant from 7pm until 11am. Having a bubble bath was what triggered it the first time, I thought it was a reaction to the bubbles as I have sensitive skin and prone to being itchy. Now I'm ok with bubbles but previously haven't been. I had a bath the other night when hot and sticky and it did help a bit.

They are repeating the bloods next week with a 7 day gap then planning from there. They want at least two readings before giving me the approval to visit family - family are far from where I am but actually nearer to a hospital than I am at home so swings and roundabouts

Good luck @Superscientist

I found the whole thing super stressful, and was terrified of the induction (was Covid times so I had to go in alone) but it really was fine.

I can imagine, I had my daughter in 2020 and did have an induction booked in after my waters went before labour but she came quite quickly so I didn't need inducing in the end.

Sorry to jump onto your thread, I just wanted to ask how severe everyone's itching is? The last few nights I've had the itching specifically in hands and feet but I'd say its between mild and moderate irritation. Other posts I've read the itching is next level and then other sources say the level of irritation varies. And edit I'm 36 weeks today.

Some days/nights I'm itching constantly and can barely sit still /sleep whereas other day/nights on and off and not too bad. I've removed my rings and watch which has helped and there's definitely certain clothes that irritate me more than others especially on my arms

Have you spoken to anyone about the itching? It might be worth a call to maternity triage or your midwife if you haven't already so they can run some blood tests on your liver.

Hi, just wondering what everyone’s levels have been as I have just been diagnosed with bile acid levels of 41 and am trying to get a sense of when they consider induction etc.

I was diagnosed at 31 weeks and am 32 weeks today - the itching is horrendous!!

I have an appointment with a consultant on Friday for something else pregnancy related but think they’re going to talk to me about the cholestasis as well.

I have found that Dermacool is quite good for some relief from itching - beware, it’s expensive though! £30 for a large bottle from the chemist!! The menthol cools things down.

Thanks for your reply. Had it again last night so I'm going to speak to my midwife tomorrow about it.

My levels are 47 which apparently puts me in the moderate class with recommended induction at 38-39 weeks.
I was told that as long as my levels stayed below 100 this would stay the same. If they went over 100 they would look to induce earlier. I'm 33 weeks today

Good luck tomorrow, they will probably get you in for some bloods to check your liver.

My results came through quite quickly. I had them done at lunchtime and the results were on the system for my midwife to see the next morning. I had a call from maternity triage later the same day checking that someone had spoken to me about the results and there was a review with a doctor arranged.

I had this but it was twenty years ago and advice is probably very different. My pharmacist would make me a mix of aqueous cream and menthol crystals , prescribed by the gp but was available without prescription. It worked brilliantly, perhaps you could ask your gp? Otherwise I spent most of the longest summer of my life laid in a cool bath, it was absolutely hellish to be anywhere else 😫.

I had this diagnosed in my last pregnancy of three - had discussed induction at 38 weeks but went into spontaneous labour at 35 weeks. My itching was relatively mild though the levels were quite high, so the consultant thought I probably had it in all the pregnancies as DS1 arrived at 35 weeks as well and DS2 at 36. So be prepared for a potential early arrival (they were all fine - no special care required )

Thanks, I've tried a few creams and they haven't helped but my skin is sensitive and creams tend to make me itchy at the best of times. I had my liver function checked in my 20s when I went insanely itchy (not pregnant) and that was resolved by stopping all creams and liquids soap products. I think I'm sensitive to sls in a lot of the products

The Dr I spoke to said the levels of itching doesn't necessarily correlate with bile acid levels .... I have packed a hospital bag for me today anyway just in case! I'm 33 weeks now est weight around 4lb so if he was to come early I know the odds are pretty good... My dad was born at 28 weeks and 2lb in the early 60s and did alright even without fancy NICUs!

Thanks for your reply - I hope your levels stay in the same range and baby doesn’t have to come any earlier ❤️ Hoping I will find out more at my appointment on Friday. Just smothered myself in my menthol cream and hoping for a night of minimal itching…🙄🤞🏻

I hope you had an ok night @hoppy1990
I woke up 4 times itching including being awake from about half 4 to half 6. I've managed to get another hour or so sleep since thankfully otherwise I would have been on my knees by lunchtime!

I have found rubbing rather than scratching a bit better as it doesn't trigger the whole body itching as much. Not having covers on hands and feet helped too as the fabric seemed to irritate them

My night wasn’t great but for a completely different reason - awful acid reflux! I’ll see what the consultant says about my bile acid levels and itching on Friday and will report back! Hope you manage to stay as itch free as possible 🤞🏻

Ask for omperazole for the reflux, I've had it on prescription for a few weeks. I don't need it that often but it helps much more than gaviscon. Eating bread seems to trigger my reflux... Toast is fine though!

I had my second lot of bloods yesterday. My bile acids have increased but still in the moderate range, I don't have exact values they aren't concerned but my liver function tests have "shot up" since last week so they are retesting those at the weekend. They were 330 last week, again I don't know exact values for this week

I had hoped my levels had dropped as the itching had dropped in intensity a little.

@Superscientistsorry to hear your levels have gone up. I read somewhere that once you have this condition, your bile acid levels won’t go down until after you give birth. Not sure if that’s correct but I will try and find out at my appointment tomorrow!

My itchiness yesterday and last night was so much worse - wondering if the heat plays a part too? I’d taken my antihistamine and covered myself in the cooling cream but it didn’t seem to help anywhere near as much as other days!

I’ve started the omeprazole for the reflux and it’s magic - I’m back to normal!

@hoppy1990 I've been told the levels can be all over the place. The midwife yesterday said she has had women with levels at 95 one week and 15 the next.
When I asked the Dr last week he said some times levels go down, some times they go up and sometimes they stay the same but the classification of low, moderate or severe is based on highest recorded reading rather than latest reason. To get the go ahead next week to visit family they need to be relatively stable but I'm getting less optimistic than this is going to happen so might need a plan b!

I'm glad the omperazole has helped the reflux and good luck with your appointment tomorrow
My itching has been worse today the heat probably isn't helping.