Obstetric Cholestasis

[Momdeguerre]

Hi,
Have had a few problems with my current pg and to add to them my midwife called me on Xmas Eve and told me my blood results were odd and that I was to go to my local hospital immediately where a consultant was waiting to see me!

Scared me stupid. Long and short of it is that I have had some skin irritation and have been feeling pretty grim. She did a blood test and my liver function appears to be knackered and, despite that fact that cholestasis does not usually appear till 28 weeks + and I am only 24 weeks, that is what I appear to have.

Have been advised that I will have to have more monitoring and that they will not look to let me have the baby any later that 34/36 weeks because there is an increased risk of stillbirth.

Was wondering if anyone else has had this and can tell me what to expect and also what to expect of a baby born 4/6 weeks early? My DS was full term - will this baby need any special care or is it just likely to mean a bit more immature and smaller???

Hi MDG! Merry Christmas.
Gosh, 24 weeks already?!

Sorry to hear you've had some problems.
I wish I could help a bit more, but I'd never heard of cholestasis until my friend had it with her pregnancy.
She developed it quite late, definitely after 30 wks, but it sounds like it was a bit more pronounced than yours, the itching drove her crazy. They induced her at dead-on 37 weeks...I was quite anxious about how it would all go for her...but the birth was quite straightforward, the baby was perfectly healthy, and she's had no further problems with herself or the baby.

I hope it all goes well for you x x x

Hi!
How are you? Yup, 24 weeks and the time is flying.

Bit fed up so far - my last pg was a breeze and this time I seem to have had a whole host of strange and unusual complications which are all driving me a bit crackers!!

Glad to hear your friend was ok, I am also itching like MAD!!! Drives me nuts. Glad to hear her birth was ok, fingers crossed mine will be too!

Hi,

That's v early to get OC so it's good that they picked it up and will monitor you from now on.

Just to reassure you the latest research and opinion is that the risk of stillbirth isn't as high as they thought. There is an increased risk, so they like to keep a close eye on it and induce early, but at present the guidelines are to induce at 39 weeks and definitely not before 37 unless your pregnancy is complicated by anything else as well.

They will monitor your bile acid levels more than liver function. They can give you a menthol-based cream to apply if you are itching and can prescribe something called ursodeoxycholic acid.

It sounds like you are in good hands- and it's very unlikely they will induce before 37 weeks so baby won't be early anyway

Good luck

Hi. Sorry to hear your problems. Only experience I have is of a friend who had this in both her pregnancies (unbelievably not diagnosed, even the second time). She went into labour naturally at around 34/35 weeks, and both babies have been absolutely fine. You have the advantage of the hospital actually knowing that there is a potential problem!

Hope everything goes well, and that there is something you can do about the itching - think it drove my friend mad!

Hi there.

Hope you're feeling OK. It's really good that they've picked up on this early on, so don't despair. At least now they will keep a close eye on you (you'll probably have to have your bloods done more regularly from here on in).

Do make sure you look after yourself in terms of getting your rest and not running yourself ragged. OC can make you feel quite tired and nauseous, especially towards the end of pregnancy, and the itchiness can drive you absolutely insane (make sure they prescribe some lotion for that if/when you get hit with the itch!).

I developed OC towards the end of my last pregnancy. It is quite scary knowing that there is an increased risk of stillbirth . Different hospitals have different attitudes towards OC, depending on the consultant. The fact is, research on OC hasn't drawn any hard and fast conclusions. Some consultants believe it only poses a minor risk to the unborn child, while some consultants believe it is quite a serious condition and you will be treated as 'high risk'. The main thing is, don't panic. Just make sure you are having your LFT (Liver function) done regularly and that you keep an eye on your baby's movements and report any changes to your midwife.

I delivered at 38 weeks in the end (Most hospitals will induce you at 37-38 weeks with OC).

For the record, my DD was absolutely fine and my liver function was back to normal within days.

Hi!

Sorry to hear you've developed OC so early.

I had it with DD2, but not DD1, and I'm currently 38 weeks pg with DC3, and so far OC free! I have been itching like a nutter, but my blood results have been coming back negative. However, I had to insist to get my bile acids done, MW seemed happy with having my LFT tested at 34 weeks, and that's it.

Still itching like mad, I went back ot my GP this time, who said the bile levels have to be done too, as last time my LFTs were normal, but my bile levels went through the roof.

I'm still itchy now, got the menthol aquaous cream a pp mentioned (called Arjun cream), but mw has given me an appointment for next week only, with no plan of further blood tests just to be on the safe side.

So all this to say (blimey, that was an essay and a half!), make sure you get checked regularly, if OC is well-managed, there is no increased risk of still birth. The increased risk comes from undiagnosed/untreated OC. Some people react very well to the Urso, I hope you are one of them.

(sorry for length of post).

Thank you all for the advice and your experiences. It really helps to hear more positive stories.

I do feel crappy and the itching is maddening but I really don't care as long as the baby is ok.

Seeing Dr again tomorrow and will ask for the cream.

Can I ask if any of you had itching on any places more than others? Just nosy really. My legs face and neck are by far the worst and much worse at night and if I get too warm or stressed!

My itchiness affected my whole body, but the most intense place was the soles of my feet. This is what alerted the doctors to the fact I had OC in the first place. I almost tore my feet off! I would wake up at 3am and soak my feet in ice cold water, then walk on the cold kitchen tiles. That menthol cream mentioned was pretty good, although didn't completely solve the problem.