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Original poster

Obstetric cholestasis - scared

39 replies

jaz2 · 05/11/2008 00:11

I know I'm jumping the gun - I've got a blood test tmrw - but I've had liver problems before - when I wasn't pregnant (due to the pill), and I'm exhausted from DS being ill for 4 weeks and having to juggle work/looking after him - so I have nothing left in the tank to deal with another problem.

I didn't have OC with DS, and am 5 months pg now.

I just need to hear that if I do have OC it's not the end of the world. I've read the ocsupport website, but am in such a state that it's making no difference. DH is just exasperated with me.

My symptoms are the same as last time I had liver problems (itchy scalp and back, and chest). Doc has ticked box for "Liver profile test" but not sure if this covers bile acid test.

Heaven knows how long the results will take - should I contact my midwife and see if I can go to my hospital (where I'm booked to give birth) to get quicker results? Does a delay make any difference (I've only had the bad itching for 36 hours)?

OP posts:
Are your children’s vaccines up to date?
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mumtomilkmonster · 05/11/2008 00:30

sorry, absolutely no idea, but bumping for you.

Original poster
jaz2 · 05/11/2008 11:49

Bump...anyone?

OP posts:
fettle · 05/11/2008 12:14

Jaz2 - don't panic, please!

I had OC with both my pg and both DC, although induced early (36 wks DD and 38 wk DS) are both healthy and normal. I too am totally healthy again now too!

You do need to have bile acid tests as well as LFTs. If you do have raised bile acids, they may well start you on some treatment to reduce the bile levels in the blood - however this isn't always the case. I didn't with DS. In both cases I was monitored every other day with CTG and regular blood tests to keep an eye on baby and my blood levels. Once they decided they had got me as far as they could they induced me early.

If you have a good MW, I would say that it is certainly worth giving her a call to discuss things through, if only for your peace of mind. Be warned though, I've had a couple of MW who still hadn't heard of OC, which did surprise me!

take care and keep an eye on baby's movements now. If you know what is normal then you will be more aware of any changes in his/her activity. If you are ever worried that they are quieter than normal, then give your hospital a ring straight-away. They would rather send you on your way with no problems than anything else.

big hugs - and try not to worry, although I know from experience how difficult that will be.
xxx

Original poster
jaz2 · 05/11/2008 12:18

Thanks Fettle.
I spoke to the nurse who did the blood test and she said that they'd do a bile acid test if the bilirubin levels were high. I hope she is right.

I'll give my MW a call, I'm just trying not to panic.

I've had the blood test done, so hopefully that should be the start of things.

It's just so hard when I'm feeling this little baby moving, and I don't want any harm to come to it.

OP posts:
Upwind · 05/11/2008 12:23

The really classic symptoms of OC are itchy hands and feet, which I have had with this pregnancy, to the point where my toes and fingers were bleeding from being scratched and I was going demented for want of sleep.

I had the tests, it took about a week to get the results but they were able to tell me when they would expected back and I was relieved to hear they were fine. You can ask them to ensure they do a bile acid test. AFAIK all bile acid tests have to be sent to somewhere in Manchester so it doesn't matter where the blood is taken.

Original poster
jaz2 · 05/11/2008 12:45

Upwind, your symptons sound dreadful. When I had my last liver problems it was my scalp/back and face that were bad...

Hmm, MW was less than helpful. Spoke to doctor who said the tests wouldn't include a bile acid test. The results from the liver function test will be back tmrw and then she said she'll decide whether I'll need a bile acid test.

More juggling of work and health...and with redundancies planned at work I could do without having to take more time out (I only work PT). Better not MN too much either!

OP posts:
spicemonster · 05/11/2008 12:50

They do the liver test first and then if that indicates it, then the bile acid test. I had really itchy skin with DS (so bad I made myself bleed with scratching) but not hands and feet and tests came back negative for OC. Mine came on mid 2nd trimester I think but didn't last long. No idea what it was about but hopefully you should be fine.

Don't google - it makes you feel 10 times worse!

Upwind · 05/11/2008 12:51

You are worried and stressed by this so I am surprised they won't just give you the bile acid test now for reassurance.

My symptoms could have been a lot worse - but they were the classic symptoms of OC so taken very seriously. And I did not have it, have no idea why I got that rash on my hands and feet but it went away. The only way to make it bearable at night was covering the affected area in sudocreme and putting socks over it so it could not rub off.

Even if it was positive it is not necessarily disastrous!

fettle · 05/11/2008 12:58

Jaz2 - don't be put off my not having classic symptoms. I did with DD - itchy hands and feet, with no associated rash. With DS I just itched everywhere! But because of my history they took me seriously immediately as I was already under consultant-led care due to the previous OC.

Spicemonster is right though - try not to google it. Too much information is sometimes not good at times like this. Wait for your blood tests to come back. I think more hospitals do the bile acid tests now - that changed between DD and DS (4 years difference) and so with DS the results came back within 48 hours.

I found work a great distraction TBH - kept my mind from itching because as soon as I started, I couldn't stop! If it gets really bad, try asking for a menthol aqueous cream - doesn't stop the itching, just calms it slightly when you've scratched yourself raw!

Take care

ohIdoliketobebesidethe · 05/11/2008 12:59

I had OC with dd2. I only got symptoms at 36 weeks and they did the general liver bloods - which were abnormal which was enough to make the diagnosis. It is very unusual to get it in one preg and not others so I was carefully screened for ds1. If your liver tests and they are still suspicious they would then go on to do the bile salts test (which is much more expensive).

There are plenty of other reasons for itching in preg.

If you do have it, apart from sleep deprivation, the risk is of stillbirth. There is thought to be a much higher risk nearer term and by being diagnosed and induced early if necessary this risk is not worth worrying about. The problem is not being diagnosed - but you are on to it.

meebles · 05/11/2008 13:06

I had OC, and had dreadfully itchy everything late on in the pregnancy which the MW dismissed as being normal. She went on holiday just before my due date, and I saw the GP instead for a normal checkup. I mentioned that I'd had a friend with OC, and asked was she definitely sure that everything was okay? Anyway, she did bloods, and it wasn't. By the time we got those results I was overdue, so they induced me as soon as they got hold of me - I was fed up with waiting, and gone for a walk up a hill to hurry things along a bit!
DD was absolutely fine, and is now pulling all the books out of my bookcase as I'm not paying any attention to her Having read afterwards about what might have been the case I feel extremely lucky that despite it not being caught, and me going overdue, DD is fine.

pregnabrain · 05/11/2008 13:09

Just wanted to add another message of support. I had OC with my first pregnancy and was beside myself with worry about it when first diagnosed. Of course, the last thing any pregnant woman wants to hear is that there might be a danger to her baby.

But, once I'd spoken to my consultant at the hospital (who was incredibly chilled out about it) and had a chat with Jenny Chambers, who runs the OC support line in the uk (def worth speaking to her if you do end up diagnosed with it), I relaxed a lot. As previous posters have said, OC is ONLY dangerous if undiagnosed. As long as you're being looked after, there is very little danger. In fact, with standard management of OC pregnancy (usually frequent monitoring and early induction) the risks to the baby are exactly the same as they are in a non-OC pregnancy.

So anyway. Try not to worry. You might not even have it anyway...

munteria · 05/11/2008 13:15

hello,

I agree with ohidolike it above....the main thing (if you do have OC - and you may not as itching is quite common) is that you are being monitored early.

it only becomes a issue really if they find it later on in the pregnancy (i.e post 38 weeks) but you are still really early so you will be fine. if you have it they can treat it easily

so whatever the result may be feel reassured that it will be under control and you will be monitored closely, so try to relax.

yomellamoHelly · 05/11/2008 13:30

I had it at 32 weeks with ds1. I think different trusts have different approaches to how they deal with it.
Actually started the day I had an appointment anyway and ended up spending hours there seeing various people and being monitored in between. Was then asked to go back in for more checks the next day and got a call first thing to bring my bag in since they might admit me. They then decided baby was okay for then and to monitor me. Then at 36 weeks and 38 weeks decided I wasn't favourable for a successful induction (and I couldn't have a caeesarean) so ended up going to 41 weeks. Meant A LOT of hospital trips for loads of tests. I was happier at home though.
Once ds1 arrived I did feel loads better and was back to normal (in that respect) a couple of weeks later.

MrsMattie · 05/11/2008 17:05

Hi all. This is a very timely thread for me, as I have just found that I probably do have OC .

I'm 37 weeks pregnant. Started having intense, unbearable itching on the soles of my feet last night. Phoned NHS Direct this morning and they advised me to go to the maternity day assessment unit at my hospital. had some blood tests. The MW just called me with the results for the liver function one and they point to OC. I have to go in at midday on Friday for the bile function results, to retest and to discuss my 'options' with the Registrar. I am terrified, to be honest. I had been planning a VBAC, but to be honest now I just want a c-section at the earliest possible stage, as have been reading about the risks of foetal distress and stillbirth

IWonderIfMamaGStillLovesMe · 05/11/2008 17:08

OC can be very saerious if not treated as the only cure is to deliver the baby. If not done so in time the baby can be stillborn.

I hope you are both doing okay and that your babies are born safe and well.

IWonderIfMamaGStillLovesMe · 05/11/2008 17:09

Keep an eye on movements too. I never got my OC tests back as DS1 had to be deliverd before they were back but he was in trouble. And cut right down his movements the day before he turned out to be born. I constantly thank God he held on for a few more hours.

MrsMattie · 05/11/2008 17:11

I am so worried . Friday seems like a long time away. My baby is moving, heartbeat was great this morning etc, but he/she is quieter than has been. hard not to wind myself up totally.

I really want my baby to be born NOW

MerlinsBeard · 05/11/2008 17:22

i had OC with ds3(last pregnancy). It was horrible to be so flipping itchy all the damn time! I was so bad at one point that i will have scars from scratching myself!!

Different PCTs have different policies for OC. mine didn't really seem to have anything set in stone which was in a way reassuring but meant i had to rely on what i found from google and MN sometimes!!

It can be scary yes, but do try not to panic. If you do have OC they will monitor you very closely. I think i was 33/34 weeks when i was officially diagnosed. In fact my levels were so high that the MW came to my house to help me pack a bag because she was sure they would admit me that night!! You may be admitted, that way you are THERE but i lived very close to the hosp so they were happy for me to come home as long as i went in twice weekly(at first) for bloods and monitoring 3x a week. I was given an extra scan at 36 weeks to check babies size in case they had to deliver him, i was given Ursodeoxycholic acid at very doses but it didn't work, was also on Vit K and i had a liver scan to check that i only had OC !

I was told i would be induced early but in the end i had to beg for a sweep at 38 weeks, turns out i was already 3cm in any case and he was born the next day

MrsMattie · 05/11/2008 17:34

Do you think I can 'demand' a c-section? I had planned a VBAC, so originally I was told I could opt for a c-section anyway, but I decided not to. Now I really want one .

MerlinsBeard · 05/11/2008 17:39

i was fully prepared to demand one MrsM. I will try and find my threads for you, i had some fantastic advice on there

IWonderIfMamaGStillLovesMe · 05/11/2008 17:46

How many movements are you getting?

MerlinsBeard · 05/11/2008 17:47

OC moan

can only find this one of use at mo...am harrassed by DCs lol!

MrsMattie · 05/11/2008 18:05

The baby is probably moving once or twice an hour - slow, squirmy movements. This morning when I was monitored the baby moved quite a bit, though@IWonder

Thanks@mumofmonsters - am going to have a look now xx

IWonderIfMamaGStillLovesMe · 05/11/2008 18:13

I always panic after my experience. 37 + 6 and nothing got this baby moving.

38 weeks baby born by emergency section. He really should have been born the day before as the midwife was crap and didn't monitor him for more than 5 minutes. Lucky for us he held on.

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