obstetric cholestasis - anyone know any more about this disorder?

[happynappies]

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I've had intense itching for several weeks now, particularly across my stomach, legs and arms. It is worse at night, worse when I feel hot (e.g. after bath or when central heating is on) and keeps me awake at night for blocks of about 2 hours at a time when it feels like the scratching will never end. When its really itchy it is like nettle rash - sort of raised bumps. These then bleed and scab etc. I asked for a GP appointment to discuss this, and was given an appointment with a triage nurse who suggested it was dermatisis and prescribed some steroid cream and told me it would take a couple of weeks to clear up. Since then I've been reading loads on the internet about itching in pregnancy and have terrified myself that it could be a more serious condition with implications for the baby's health (I'm 33 weeks now). Does anyone know how to tell the difference between harmless and harmful itching disorders? Should I ask for a blood test? Any advice gratefully received.

Firstly don't panic as you are only 33 weeks. Usually, they like to deliver by 37 weeks.

You need to have a liver function and bile acid blood test to diagnose this. Your midwife can do this. Or go to day assessment unit at hosptial (near labour ward probably). Steer clear of this GP/nurse in future - it is very stupid not to give a pg woman a blood test when she complains of itching in late pg.

I had this with both my DCs and they were both induced at 37+0. Both are fine, so try not to worry.

Thanks for that crokky, I've got a mw appointment coming up so I'll specifically ask for that test. That's what I was wondering - how could the nurse 'know' what the rash/itching was without a blood test to rule out other conditions? I find their whole attitude towards pg women at my surgery very dismissive and unhelpful.

You do need to ask for a blood test and keep an eye on movements. Any change at all - less movements or more movemtnst - get it checked out.

When is your MW appointment? Don't wait too long as they can start you on medication now if you have OC. I was prescribed vitamin K (to aid blood clotting for myself and babies). There is also other medication they can give (think it's urso). If you do have it, push the hospital to book your induction. I had my OC with DS at one hospital and then with DD at another hospital. The first hospital had everything under control - diagnosed on the day, induction booked on the day, medication started on the day. The second hopsital were very laid back about it and I had to push them to get stuff done. There is a rather confusing guideline about this condition and there is currently an ipetition going to improve this as some staff think it's OK not to treat it.

My MW appointment wasn't until next Wednesday, but I've been to the day assessment unit at the local hospital and had bloods and liver function tests taken - got to wait until Monday to get the results back. As I haven't got the rash on the soles of my feet or hands, mw suggested it is less likely to be OC, but I feel happier knowing I've had the tests to rule it in or out one way or the other. I've got to go back on Friday to have a second blood test to confirm/check things - thanks again for all the sound advice, I'll keep you posted.

You are definitely right to get this checked with a blood test. I had OC and only very mild itching but a very on the ball doc at the hosp spotted it and sent me for blood tests (liver function tests) "just to be on the safe side". Turned out she was right to check as it was OC.

As other people have said the procedure if it is OC is to induce at 37 weeks so don't worry too much about it, you still have time to get things all sorted.

Quite a few docs and MWs seem to still think OC is v rare whereas it seems that actually it's not that rare but often goes undiagnosed.

Good luck

I had severe OC in my 3rd pregnancy.

There are 2 kinds of itching in pregnancy though, one is OC and neds treating and one is something like puritas gravutas or something like that which sounds like (in my untrained opinion) what you have.

I had no rash, it wasn't my skin itching, the way i describe it, it was my blood itching.

Do ask your MW for the liver function tests (LFTs) to put your mind at ease though.

OC itching is characteristic in the hands and feet (as well as elsewhere after a wee while)