Raised ALT, low platelets but doctors doing nothing

[Mum2BeRants]

I’m looking for anyone else who might have had raised ALT in pregnancy and what did you do.

I am under a consultant as I’ve had low platelets throughout the whole pregnancy (100-150,000) but they really don’t seem concerned about me at all. I’ve had 2 in person appointments where they basically wanted me in and out in 5 mins and I’ve got a call tomorrow when I’ll be 38 weeks, which should have been for when I was 36 weeks. When I’ve called to try and speak to anyone / check anything in between appointments (which have been every 2-3 months) they have refused to speak to me.

Over the last 3 months they’ve done 3 liver function tests all of which have come back abnormally raised. No further investigations have been done because after the first 2 they just kept saying: it’s probably a fluke. After the 3rd high result on Friday I feel like surely this needs to be looked into, it’s not just random transient high results!

Because of this approach, no further tests have been done to rule anything out E.g. HELLP syndrome, gestational diabetes, obstetric cholestasis. And now I’m panicking because at 38 weeks it’s so late to be investigating this.

And this is on top of me being in the hospital every 1-2 weeks for reduced movements.

I really need a plan for tomorrow to stop then fobbing me off again. My anxiety is absolutely through the roof and I’m not sure what I should be pushing for.

a platelet count of 100-150 that's relatively stable is common in pregnancy and isn't usually a problem. The liver enzymes need interpreting in context (including pre-pregnancy tests, the pattern in which they're raised now/how deranged they are/whether they're stable getting worse, and symptoms, why you're having repeat episodes of reduced FM, etc etc). There may well be nothing much that needs doing apart from monitoring. Obstetricians aren't usually ones for taking a relaxed approach to things like HELLP so it's probably reassuring that they're not worried.

Thank you it's reassuring to know that maybe I'm just worrying unnecessarily.

I actually had a few liver function tests just before falling pregnant for another reason and they were always normal. They're consistently 4x higher now and outside the normal range although not insanely high and haven't increased, just haven't gone back down either.

No reason has ever been found for the reduced movement, it's just been put down to the placenta and baby not having a pattern.

I mean maybe there's nothing to worry about I'd just feel better understanding how and why the related conditions have been ruled out.

Hope the appointment goes well. Might just be one of those things or might be something that needs an eye keeping/things doing - hopefully they can come up with some ideas but sometimes it does take time to see how things are developing. Keep going in if there’s reduced movements or you get new symptoms.

I have raised alts but also high bile acid and the dreaded itch.
I'm on weekly bloods and am having a liver scan, they have done full blood work up a couple of times including clotting etc. one of the clotting results came back raised but this is an unreliable measure in pregnancy so they have me on blood thinners whilst they investigate
I've been told it's likely within 6-8 weeks of giving birth my levels for both will return to normal
I'm 36 weeks, I've been told the raised alts don't change their decision making reinductions etc but the bile acid would.
My alts have been between 300 and 650 and my bile acids between 20 and 79 so the current plan is to induce at 38-39 weeks

They have taken my liver quite seriously but I have also been in for fatigue and not being able to stay awake and that's getting dismissed so I completely understand how frustrating it is for something not being right but not being investigated