Obstetric cholestasis - scared

[jaz2]

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)?

slightly off-topic but just to say I had OC with baby 3 and we were both fine. BUT I subsequently had bad gallstones and I had not realised there could be a connection so bobbled along with gallstones until got into quite a nasty state.
so, probably not at the top of your list of worries at the moment, but just something to be aware of in future if you do get foul abdominal pains.

Mrs Mattie: sorry you have been diagnosed with OC. I'm sure you can demand a CS: it just requires you to be dogmatic enough with the right people - not what you really feel up to in these circumstances.

Against my better judgement I did google OC last night (plus on MN) - and whilst I did find things that frightened me, I also read quite a few reassuring things. But then one always thinks the worst is going to happen.

I'm very much hoping that the results for me come back negative (tho I am SO itchy I doubt I will believe them, as the symptoms are the same as last time my liver went crazy - and then it took 3 weeks of harrassing doctors to get them to believe it wasn't a pollen allergy!). I really don't want 4 months of (extra) worry ahead of me.

I just want to focus on getting rid of the cold/conjunctivitus (given to me by DS!) and general feeling of stress/exhaustion from juggling things. And i'd like baby to be bouncing around happily while I'm doing so!

Good luck jaz2. Hope your results come back negative xx

Mrs Mattie - I think you can demand a c section but you may have to be bolshy. ultimately if you say you are not prepared to accept the (tiny) risk of rupture then they are kind of obliged to give you one.

When I had to check foetal movements they always seemed to barely move. It is really hard not to be paranoid - esp when they seem to sleep for 2-3 hr stretched sometimes. They usually have a pattern of eg being more active in the evening and if that changes then I would ask to be monitored. I hate the way (usually male) consultants ask you to count the movements as if it's that easy. I was once told to count every burst of activity (ie if they kept wriggling just count as one until they've had a decent pause) as 1 and as long as I got to 10 by midday that was enough.

HTH

Hello. Mrs Mattie, I had OC in both my pregnancies. In my area, I was told that after an emcs first time, if I got it the second time I would definitely have a cs as they would not induce and the policy was to deliver at 37 weeks. I had the cs at 37 + 1 for DS and he was fine. I was induced for DD at 37 weeks but she didn't arrive until 37 + 3 (induction shocker!!) but she was also fine.

OC is hellish but it is taken seriously, just prepare yourself for the fact that you could be having your CS without much notice after your appointment on Friday. Just look at it as a chance to meet your baby earlier than expected.

Good luck to OP too. I tried to post to you earlier but my computer wouldn't work and I've just come back and seen you've now had lots of messages. You do seem fairly early on, my itching 2nd time started at about 28 weeks but didn't show up in my blood tests until 34 weeks. I was monitored from as soon as I was itchy though, which made me feel much reassured.

Hi there.

Thanks for your messages@ohIdolike and strawberrycornetto

I'm having a hellish night - feet are burning with the intense, horrible itchiness and I feel very sick and unable to sleep, although baby is moving a fair bit at least.

I'm wondering if I should go back ot the hospital tomorrow, as I really don't feel well.

OP - hope you're feeling OK. Sorry for hijacking your thread!

Do go in if you're that unwell. Esp as weekend coming up so they may well put you off to Mon if you wait for your Fri appt.

Isn't it odd when you can't wait for the baby to arrive knowing that for a few days at least you will get more sleep?

Mrs Mattie, I really feel for you. In the last week or so before DS arrived, I was awake half the night and often up on the internet in the middle of the night. I would go back in too, and push to get a cs booked, it would be good if you could get booked in for tomorrow rather than wait until Monday.

Good luck, I'll be looking out for your birth thread.

Oh, just so you know, my itching was better after DS was born but didn't clear up immediately, it still went on for about another week. With DD it was gone immediately.

Mrs Mattie: glad my original pot was useful. I can understand why you are worried sick. The first night I was so upset I slept on DS's floor, as I needed the comfort of being near him (I would have got in the cot with him given half a chance!). Please do be persistent with what you want in terms of a CS and its timing.

I had my Liver profile test back today and it was normal, tho it didn't include a bile acid test. The doc said she would ask for one to be done ("if she remembered") on my original bloods but might need me to go in for another blood test if they couldn't. I said I'd call next week to confirm what was happening. Not ideal, but I wasn't able to be stroppy having nearly fainted on the Northern Line, collected DS from nursery, mobile ran out as I tried to call doc so had to go into the surgery with a tired and stroppy DS to wait to speak to her. Ever thought that "life" had it in for you?!

I gather from other posts that the bile acid test is important (?), so whilst I am slightly more at ease, I won't relax yet.

Hi all.

jaz2 - I have had a few stressy trips to the doctors recently exactly like you described (tired, ratty toddler etc). Hellish. Glad your first lot of results have come back OK. Crossing fingers for you that all turns out to be fine.

strawberry and ohIdolike.. - thanks for checking in with me

I ended up ringing the hospital at 4am yesterday morning and was told to go in. Had a very frustrating few hours on the Labour Ward while they tried to find a doctor to see me. Eventually they chucked me out at about 10am (no rooms for me to sit in) and I had to wonder the streets of central London for an hour, delirious from having had NO sleep for about 36 hours. I must have made a very strange sight - heavily pregnant, sleep deprived woman in grotty tracksuit wondering down Tottenham Court Road and stopping every 2 mins to scratch her feet through her Ugg boots .

Eventually they phoned me and told me to come back and the doctor would see me, but after a two hour wait in a boiling hot waiting room, I eventually burst into tears and had (lack of sleep induced) hysterics in the waiting room - seemed to do the trick ad they found me a nice midwife and a room. Eventually the doctor saw me and prescribed piriton & some sort of cooling menthol foot cream. they monitored me and the baby for a few hours and said all seemed fine. Also, my liver function results are only just on the 'not normal' side of normal. Told them I wanted a section, but the doctor said she really didn't think my results warranted an emergency delivery, and booked e in for an elective at 39 weeks. i have to go back on Wednesday for a second lot of blood tests and to be monitored, and apparently if the situation has got any worse then we can talk about an earlier delivery.

i was sort of happy with that yesterday, but after the night I've had I'm starting to think I should phone the consultant and push for an earlier delivery now . The piriton / lotion didn't touch the itching. I spent the early hours of the morning with my feet plunged in a bowl of ice cold water,sobbing. I just fear for what state I will be if I have to put up with this sleep deprivation and itching for another 2 weeks minimum , especially as a I had a traumatic time with my last birth and ended up with PND...

I always seem to come away from hospitals feeling more confused than i did before I went in!

(Sorry for the essay!)

Oh Mrs Mattie - I really feel for you. I remember that awful itching so much. Piriton won't touch it if it is OC. I found wrapping my feet in wet towels allowed me to get some sleep at night. Well it at least allowed me some time to stop itching to get to sleep until the itching woke me again!

Take care and at least they are monitoring you - baby is better off inside you for a couple more weeks really if they are keeping a close eye on both of you. But make sure you are keeping an eye on movement regularity.

Jaz 0 pleased your results came back normal - I'm not sure but it would be unusual to have normal LFTs and raised bile, but I'm no expert!

Take care

Mrs Mattie

Piriton didn't touch mine at all. Have they given you Urso?

Jaz, glad your results are normal, have you your results there? the ones they kept looking on mine were AST and bile acids/salts

Poor you Mrs Mattie. Somehow I hope you get some sleep tonight - no wonder you are in such a state after so little sleep. It does sound like they have monitored you (tho it was awful that they kept you waiting until you were feeling even worse) - and have made a rational decision.

I completely understand your feelings about wanting the baby out NOW. But (if you can) give yourself a stern talking to, and for the sake of your baby, who must be willing you to stay calm (as well as looking after him/her in terms of OC), try to get into a calm frame of mind such that you manage a few hours sleep tonight. Could you prop yourself up in an armchair with your feet in some very cold water - and try to sleep that way? Don't get upset if you can't - listen to the World service or something - I find the calming voices ion that very therapeutic. Big hug.

Fettle: I'm hoping the fact that the liver profile was OK will mean the bile acid also is.

MoM: I didn't get my results, the doc was looking at them on the screen (she is an inscrutible eastern european lady - I don't find her easy to talk to - tho she has been wonderful with my sons bronchiolitus problems). She just said my level was 12 (and the safe level was less than 17) and that my iron was low (must be run down - previously it has been very good). I did try to ask a follow up question - but DS was chattering away and I felt bad enough ambushing her (rather than phoning - due to my phone problems).

Its my scalp, chest and back that are itching - but unless I get hot the itch is bearable. I'm just glad I bite my nails otherwise my chest would be ripped to shreds! I just can't understand why the symptoms are so similar to when my liver went haywire last time (when they found I was "allergic" to the Pill) - this fact stops me from being convinced that all is OK.

Jazz, good news. Just make sure they keep an eye.

Mrs Mattie, I am really sorry because I know exactly how uncomfortable you will be now (that's a huge understatement I know). How many weeks are you now? I would push for a delivery earlier than 39 weeks. I had to argue really hard because my blood results were slow coming back so they had the LFTS but no confirmation though the bile acids. I think the reason they try to balance it and delay if possible is that there is a lung condition that can affect babies who are delivered via a cs, especially if they are delivered early, Both of my DCs had this and spent 5 days on special care with cpap and antibiotics. I think that's unusual but they do bear it in mind so they won't deliver early unless they know they need to. BUT, if I was you, I would push them hard if you are over 37 weeks.

I was given puriton but it won't help. For me, hot baths seemed to numb it long enough to get to sleep but then I woke up after a few hours. If was really miserable, its funny to think this time 4 years ago I was in labour with ny DD and going through it. With DS this time though it was horrific. I think it also makes you feel ill although you don't really realise it until afterwards.

I wish I could offer you a good tip to take the itching away, but I am thinking of you. It won't be long now til you meet your baby and then the real lack of sleep will start.....