Obstetric Cholestatis - very high ALT and Bile Acids - worried!!

[CustardCream31]

Any words of wisdom/own stories shared appreciated. Interested to know if you had this condition, what your levels got up to and when you were induced? Aiming for a vbac this time, after a similar issue (but never diagnosed with OC last pregnancy) which was an induction turned EMCS after 5 days of hell.

Am currently 34 weeks.

ALT currently over 700, and recent bile acids 93 (have been having readings of 10/11/40/20 over the last fortnight). ALT has been steadily climbing for months now. It got to over 1000 with normal bile acids last pregnancy.

I’ve had such a restless night worrying about needing to be induced asap and her not being ready and causing more issues that way. I’d like to hold out until 36+ weeks ideally, as I think that’s when the risk of stillbirth increases?? So much conflicting information given on Google/Mumsnet/NHS trusts/medical papers.

I’m being tested twice weekly and under consultant care (seeing her again on Monday).

Thank you in advance!!

Morning, I had this in my second pregnancy. Are you having growth scans? I was due to be induced at 36+6 but ended up being induced at 36 weeks because of OC. Luckily my waters went on their own accord. It was miserable to have, I really sympathise. Are babies movements ok? Just be super super cautious if any change atall go up to your local epu and get monitored. I remember going up quite a lot in the last week or two before she was born. I really feel for you OP, it was horrible to have. Sending hugs. X

Ah thank you, it’s rubbish isn’t it…
Yes, she’s active as anything at the moment thankfully, and will deffo watch her movements like a hawk.
Had a growth scan nearly two weeks ago, all measuring fine. Another one due in 2 weeks.
I don’t have any itching thankfully. Just feel tired and bit sick sometimes, but not sure if that’s normal pregnancy stuff or not!
Was your little one ok at 36 weeks? Any NICU time? And was your induction ok? 💐

I had this, i knew it and im sure the midwife knew it, but they said i didn't! Tested regularly, then when my levels elevated they called me in, finally told me I had it, and booked me for an induction the next day, at 38 weeks. I didn't go terribly smoothly but could have been worse i suppose. All in all it was an unsatisfactory experience... sounds weird, but I'm not sure how else to describe it. The relief from itching was immense... it's good if you at least don't have to experience that, it totally ruined my already awful sleep in the final few weeks.

Edit as i forgot to say they didn't really tell me the levels, so I'm not too sure what they were. I think i asked and got something after they first tested, but I can't remember what they were.

Hi, I had this with my daughter. Diagnosed at 34 weeks and they put me on medication that only just kept it at bay. My levels did get very high though, can't remember exact numbers. I was induced at 38+4 after a big argument with my consultant as she wanted me to go to 40 weeks!!! 😱 I put my foot down as I was so worried about stillbirth, lucky I did as on the day I had her my levels were through the roof!!! So if they try to fob you off with waiting longer than necessary please advocate for yourself, it's a dangerous condition towards the end of pregnancy. This was 16 years ago though so I don't know if policy has changed now? Try not to worry too much though at this point, my daughter was absolutely fine in the end x

Thank you ladies. Such a stressful time isn’t it!! I keep reading different things/induction triggers based on numbers. Head is spinning!

I’ve been on Urso (1000mg per day) since Monday. The on call doc I saw last weekend scared me and said she would need to come within days 🥲 but then levels went down a little, but now jumped up. I’m worried they will induce me too early rather than too late. It’s finding the balance between keeping her cooking and avoiding stillbirth. I’m so confused 😣 I know I just need to wait to speak to consultant on Monday and try not to stress. But easier said than done!!

Oh I'm sorry your levels are up again. It's so stressful!
I think even if your levels go over 100 they still will wait until 35 weeks to induce. I'd get ready for going in though.

A week post induction, and I know I did get to 37 weeks. How much better I'm feeling now I do almost wish they had induced at 35-36 weeks as that's when my physical health massively deteriorated.

You have to look after yourself lovely. Have a chat with them about timings and when would be optional for you and baby. You have to look after yourself too lovely

I’m 36 weeks and developing this. The itching is so miserable but my levels were just outside of normal on the first testing. I’m waiting to hear from the second. The baby continues to move well. All the midwife said was not going beyond 40 weeks for me, but it all started a lot later.

@Superscientist hello here too! Thank you. Yes I hope they do wait until 35/36 weeks…. In hospital again today and tomorrow. We shall see….. so glad you are feeling better! Such a relief.

@FunnyOrca sorry you’re developing this 😣 it majorly sucks. Keep us posted.

feeling worried about today’s bloods……..

@CustardCream31 how are you getting on?

Sorry for my radio silence!! Been ticking along with yoyo-ing bile acid levels. Feeling ok in myself and baby is doing fine. Was admitted to hosp at the weekend as was getting painful tightenings and am showing 2cm dilated. Poss spontaneous prem labour, but home now and waiting and seeing. Induction booked for next Tuesday at 36+3.

how are you doing @FunnyOrca?