obstetric cholestasis - itching driving me mad...any advice..?

[blueberry69]

I have just been diagnosed with OC at 31 weeks. Being closely monitored and facing an early delivery at 37 weeks (although potentially earlier if baby in distress).

Has anyone else had this and if so do you have any advice to reduce the itching. It is unbearable and is stopping me sleeping. I have been given what seems to be the typical selection of OC medication: incl UDCA, vitamin K and aqueous menthol cream, but wondered if anyone knew of anything else i could do to get some relief (including diet/lifestyle)

Thank you

I had this, but not until 39 weeks, it was hell and they induced me the very same day it was discovered.

Try a bath with some bicarb of soda in - that helps with chicken pox itching, likewise a clean sock with some porridge oats in, tied in a knot over the running tap when filling a bath might help too.

Please keep an eye on this - TMI alert, my poo went yellow which meant that my liver wasnt working properly, I think if that happens you need to get in touch with your MW team.

good luck bluberry. ((hugs))

Thanks thehillsarealive . Have tried the oats which are great when actually in bath but effects seem short lived! Will def try bicarb of soda too.

The consultant/midwife team seem to be taking it all very seriously and i am being monitored to within an inch of my life! But thanks for extra info . Far from being TMI it sounds worth keeping an eye out for any odd changes - pee already quite dark which apparently is another sign of poor liver function.

Did the itching go quite quickly after you delivered (please say yes, please say yes!!)

I developed this in my second pregnancy at about 33 weeks. I had a c-section at 37+5 (couldn't be induced as had had previous section). The itching made me miserable. You have my deepest sympathise.

Where is it worst for you? My feet were the worst. I could have torn off my soles, honestly.

To be honest, I didn't find any long term relief, but found keeping cool mildly helpful. I used to soak my feet in cold water, apply refrigerated menthol aqueous cream and then dry my feet off and walk bare foot on cold surfaces (tiled floor in kitchen). I would wake in the night and go throug this little ritual

The itching disappeared the moment I delivered, thankfully, and my liver function was back to normal within 2 or 3 weeks.

Awful bloody condition, though - you poor thing x

Thanks APassionateWoman - it is actually quite a comfort to know that someone knows how dreadful it is and even better to know it can disappear instantly after delivery. If only i can get through the next 6 weeks without going mad!! My feet and hands are the worst but to honest it is everywhere. I'll definitely try keeping the menthol cream in the fridge - seems like a great idea .

sorry blueberry, have been out most of this afternoon.

Immediately after delivery the itching stopped - because the big lump of baby was removed from squashing my poor liver.

there is hope, but please keep yourself cool and try not to itch.

Hi Blueberry
Ive had it with all 3 of my pregnancies.

Ask your consultant or Gp if they will prescribe piriton, they did for me and it worked wonders.
do make sure you get it prescribed as it is not suitable for everyone, other then that all the above sounds good

Hi Blueberry!

I had OC with DD2, twas awful. I scratched myself raw and was induced a few days after diagnosis.

The only thing that really helped was to keep my hands and feet elevated. Menthol cream sort of helped as well. No medication helped at all (hence the induction).

However, OC did not come back in my third pregnancy! Woohoo!

So hang in there, it'll all be worth it in the end when you cuddle your gorgeous baby.

So sorry you have this - it's HORRID!!

Are you going in for repeat tests regularly?
Have you had a liver scan?

Be prepared to deliver anytime from 32 weeks if your levels get too high.

Nothing helped me at all unfortunatly, keeping cool helped a bit but it was only delivery that 'cured' me.

Thank you ladies

Good point to be ready to deliver anytime WhiteNoise - did a little bit of organising yesterday but am a long way from being ready. We still have builders in the house! Having a bag packed could help relieve a little anxiety so will get that sorted.

I haven't had a liver scan - did you have one and what did it show up?

I might be the only person enjoying the new cooler weather! Sorry but am praying for lots more of it

my friend kept a cold spoon in the fridge for when the itching got really bad in the night.

Also milk thistle is meant to be a good liver cleansing supplement, but you must check with the doctor.

Hi,
I had this too and found piriton really helped,also was given some aqueous calamine cream which I kept in the fridge and was heaven when applied. My dd was delivered at 38 weeks by c-section. I had growth scans, liver scan (which is just to check it looks ok and def is just cholestasis) and I had to go in the the ANDU everyday for blood tests and monitoring. I've been warned I have over 70% chance of getting it again this time but I've decided I will go more low key with the monitoring as they went for overkill last time!!
My itching also stopped once my baby was born and all follow up check ups were fine too. They won't deliver you unless your levels are sky rocketing uncontrollably but usually like to deliver between 37-38 weeks depending on the cosultant you are under. Best of luck

My liver scan was to cherck that my liver was working and it was only cholestasis. My levels were thru the roof and out of control. URSO and piriton and cream did NOTHING!

Also, gather as much info as you possibly can about delivery dates. My hospital were so vague and didn't really know much about OC.

Hello. I had this in my two pregnancies. Agree that it was horrible. Both times I was delivered (induction first time, elective cs second time) at 37 weeks.

The only real comfort I found second time when I had it for longer was being in the bath or shower so I had lots of both but it did make me feel rubbish.

First time it vanished immediately on delivery. The second time I was probably still itchy for about another 2 or 3 days, although not as badly as before the delivery.

Good luck, I do hope that it doesn't get too bad for you.

hi, i am 34 weeks and for the last week have had insanely itchy feet (soles) and hands, as well as belly (but not so much). i thought the itchy feet weredue to a pedicure i had last week and had used the foot bath at the salon and was annoyed as thought i had picked up some grotty infection, but then hands started too. also had terrible insomnia, when am really tired but then get to bed and am wide awake. just wondered if this was your symptoms started? am planning on calling midwife first thing tomorrow. My wee has also gone darker but i thought this was just due to me being run down at the moment?

how bad was your itchiness? i have long nails at the moment and i HAVE to scratch with my nails, rubbing the soles of my feet does nothing..... am praying i dont have OC....what are your thoughts? xx

Hello Virgo. I hate to say it but it sounds awfully like my symptoms and i would urge you to contact the midwife as soon as you can to ask for a liver function blood test which can confirm whether or not you have OC. They will test the level of bile acids in your blood amongst other things. If this is negative and the itching continues ask for another test in a weeks time.

I have itchy skin, disturbed sleep, dark pee and a reduced appetite. My itchy skin is all over but concentrated on my the palms of my hands and soles of my feet. It appeared relatively suddenly, got worse quite quickly and is very hard to relieve. It gets so bad that I have found relief from rubbing my feet on the door mat and using a hard natural bristle brush on my skin. Do be careful as i have drawn blood in my frenzy to relieve the itching. Putting an ice pack on my skin (frozen peas would do) helps enormously and a cool bath is probably one of the things I have found to help the most and have even hopped into one in the middle of the night. I use oats in the bath to help relieve the itch too - put porridge oats in either a bit of muslin or a sock and squeeze gently into the bath water and over your skin. I know it is really hard but the best thing you can do is to avoid the first scratch and stay as cool as you can.

Don't worry or panic as it won't help you to sleep. The good news if you do have OC is that it should be taken seriously by your midwife/consultant and you should then be monitored closely. I have been told they will plan to deliver the baby at 37 weeks but earlier if it is in distress - I am only 32 now so will have to get through the next 5 weeks!

This website may help give you a little more info www.ocsupport.org.uk. Let me know how you get on. x

thanks for that blueberry, just had quick look at website, and interseting as was diagnosed with a viral infection last week as have been feeling so tired and exhausted, and have spent the last three days in bed or on sofa as have felt so ill. actually thought i had a chest infection but doctor said not bacterial and is viral, so just paracetamol and bed rest, but being run down ties in with the OC symptoms. will def give midwife a call in the morning.... will keep you posted x

I agree virgo, it DOES sound like OC, PLEASE get checked out!

I found the UDCA kicked in after a while and reduced my itching, which was brilliant, but up to then, I used to keep my feet in a bucket of cold water (even under my desk at work!) and at night, I'd keep a bath of cold water run. Additionally, it helped a bit, but calomine cream (rather than lotion as its thicker), kept in the fridge and applied liberally helped.

Like someone else said, it was the feet that was the worst, and at night too.

The itching went almost as soon as I gave birth.

update - i called the midwife this morning and he told me to get some Piriton type stuff to use for a couple of days and i have my next check up on thursday anyway so if itching hasnt stopped by then it will be blood tests for OC. I kept my feet in cold water last night for bit before i went to bed and it helped a bit. no itchiness now but maybe because am busy at work (ahem, this is jsut a 5 min break) so cant notice it as much? midwife also said if itchiness is more generalised then will do liver function tests otherwise if just hands and feet more likely to be hormones etc. which kind of contradicts what the website says....

Virgo, you are 34 weeks, he should be taking this more seriously. It is a cheap and simple test - if I were you I would INSIST the test is done, he should not mess with you like this. Ideally he should be doing a Serum Bile Acid test as well.

www.britishlivertrust.org.uk/home/the-liver/liver-diseases/obstetric-cholestasis.aspx - download and print off the PDF and take it with you. Post on the ocsupport website - they are also on facebook.

I completely pissed off my Dr when I was pregnant, he was just as bad as your midwife, but guess what? I was right and he was wrong!

Virgo - one of the symptoms is that it's worse at night, so do get it checked asap. You sound like a textbook case. Midwives are mostly terrific, but they're not doctors and don't all necessarily know the non-standard things if they haven't seen them before.

Hello Virgo. Your midwife has it wrong - if itching is concentrated in hands and feet, especially at night it is more likely to be OC not less likely (although it can also be all over body). Please don't take no for an answer and insist on the test asap. As MaryBS says you need to check for bile acids which is done via a blood test.

I have found that of all the things i have been given by the consultant piriton has helped reduce the itching the most but it hasn't of course dealt with the underlying condition. So if you do take your midwife's advice and take piriton and find the itching subsides it doesn't mean the OC has been treated.

I would expect your midwife to run the test and if OC is confirmed for you to be monitored very closely and then delivered at 37-38 weeks.

Hi all, I'm 36 +1 weeks pregnant and am suffering badly. I have had itchy skin now for 4 weeks and it has over this time become worse and worse. The itch started on my palms and soles of my feet. It has now spread everywhere(even my eyeballs itch!), it is worse at night. I am typing this at 4am having spent the past 2 nights pacing the house itching.I have had less than 3 hours sleep over the 2 nights. I am at breaking point, I just now want my baby delivered. I had my first baby at 35 weeks (naturally) and she was fine. Do you think if I go to emergency and explain my desperation, that they will deliver? I am so desperate that Im looking up ways to induce labour myself (castor oil etc) but would much rather it was done by the hospital. I just dont think I can take another night like the past 2. Nothing seems to be helping, I have taken piriton, used calamine lotion, had cool baths, used ice packs but none bring enough relief to stop the itching. Any advice would be greatly appreciated. You all have my deepest sympathy, I would never have believed that itching could cause so much distress.

update on me - had bloods taken last Thursday, got called in for docs appt yesterday - ALT levels were 'high' but not too high, GP asked for weekly liver function tests - said if no change over next few weeks then no further action to be taken, but if they increase then will look at doing something. am glad it is on their radar at least - was quite surprised when he said in his 25 years of being a GP he had never seen a very serious case where they had to induce someone...

so off for weekly blood tests....cannot wait to finish work now at the end of next week....

That's good to hear Virgo. Did he look at the bile acid levels as this is the most important measure. My consultant has been getting weekly bile acid levels and ALT from blood tests - of the two he pays much more attention to the bile acid levels and this seems to stack up with all the research i have done. Can you not ask him to get the bile acid levels too? High levels are considered to be above 10 but below 40 and very high over 40.

Fedup - am sorry not to have responded earlier. Your OC symptoms sound dreadful and you have my full sympathy - I know what you mean by itching eyeballs...hideous. Have you been to see your doctor/consultant to see about medication to help relieve the itching or early induction at 37-38 weeks - you are so nearly there, I hope you can hang in there. The good news seems to be that the itching goes after delivery.

hi all, i have beem summoned to the GP again followinf my latest liver function test - just wonder what level of bile acids are classed as 'high'? last time i saw the doctor he said as long as they didnt increase i would be ok, but didnt actually quantify what the levels were. am going to ask what they are at next appointemnt but just wondered what your levels were so i can do a crude comparison. itching is definietly worse the last couple of days. 37 weeks tomorrow and not ready for induction yet - still need to buy half my stuff! not seeing doc til monday though so have the weekend to do mad dash to mothercare/boots etc!!