obstetric cholestasis

[CarlyP]

I had this with ds2. was induced at 36wks. anyone had it again with another pregnancy...and did it cause any probs?

thanks,

Carly x

try searching the archive, a mumsnetter called prufrock is a bit of an expert on this. hth

Yes, I had it with a second pregnancy (and first!). I was told you are 90% likely to get it again. I became a bit of a fiend on the subject, and volunteered for the research into OC

www.britishlivertrust.org.uk/content/diseases/obstetic_cholestasis.asp

There is also a support line, Jenny was fantastic when I was going through it all, and knows a LOT about it:

www.guide-information.org.uk/guide/searchindexdetail.lasso?RecID=G30199

I've had OC three times now. i had to be delivered early with the last two and the itching was awful, but they gave me ursofalk tablets which helped a lot. Jenny Chambers is just great and full of info. I do get monthly itching now after the 3rd one which i didn't get after the 2nd but the my daughter was worth it!
i am also a research lady and gave blood and a piece of the placenta to them. I got it earlier and more severe with each pregnancy.

Amity1975,

when did u get it in each preg. they said i prob had it in 1st but i was induced at 36wk for othe reasons, i had it from about 30wks with 2nd

thanks

cx

Amity1975........are you there?!!!

I know I'm not Amity, but if it helps, I started getting it about 27 weeks. I had it worse first time, but that was because it took me a while, first to go to the dr, then to get diagnosed. Second time I was expecting it and started treatment as soon as the itching started

so maybe with no.3 id get it form 24/5wks. oh blimey. thats not great!

cx

I think it generally kicks in from 26 weeks onwards. Look at it this way, the earlier its diagnosed, the more time they've got to get it under control!

What did they treat you with last time?

TOTAL OF 9 TABLETS A DAY!! VIT K SOMETHING TO KEEP THE BILE LEVELS DOWN, BLOOD TESTS EVER OTHER DAY AND MONITORING AND INDUCED AT 36WKS

I only took vitamin K in the last 2 weeks, and depending on the strength of the tablets for the Urso, it was 1 or 2 tablets 3 times a day, blood tests once a week. Scans every 2 weeks and foetal monitoring if I needed it. Induced 37 weeks the first time, 36 weeks the second time.

Blood tests every other day isn't a lot of fun!

I developed gallstones between my first and second, which is another 'side effect' that can happen, so I had my gall bladder removed!

I have 1 gall stone!! opted not to have it removed as 2 babys under a yr and an operation didnt go hand in hand at the time!!!

maybe after no.3 at some 'good' point ill have to get it sorted!

thanks for your replies.

cx

I had cholestasis from week 25 with my first child, then week 38 with my second child and no cholestasis at all with my third!! All births were still induced "just to be on the safe side."

With child no. 1 (Alison) I was hospitalised from week 30 (not good for the sanity) but my liver enzymes and bile salts were dangerously high and I needed constant monitoring. I was also constantly monitored during the birth. My little girl was healthy and there were no complications.

The itching with baby no. 2 (Lewis) during pregnancy was only very mild for the last 2 weeks. And no itching at all with my third (Matthew.)

Now we're hoping to have another one!!

Had O.C. with all three pregnancies, each time it got more severe. Also had gallstones and had gallbladder removed after second birth.

I was advised never to have another baby as it was coming earlier and more severe each time. I was 26 weeks the last time. Nightmare.

I've had it twice now CarlyP, and it's a large reason for me not to have another baby.

I developed itching at 13 weeks in my first pregnancy. But as my LFT's and bile acids were not raised nobody believed me. When they finally deigned to test my blood again (I think I was about 26 weeks) my ALT levels were through the roof and I was hospitalized and deliverd at 36 +5 weeks.

2nd time I demanded weekly blood tests. Itching started around 13 weeks again, but LFT's only elevated at about 18 weeks, from which date I was on v. large doses of urso (newish Italian study has shown increased success & no side effects with mega doses so that might be why you are on the 9 tabs.)

Vit K is not for bile acids, its because a side effect of the urso is a Vit K deiciency, which can cause your blood to not clot. You shouldn't really need Vit K unless your blood tests show ow cloting factors, but it won't hurt you to have extra.

The CTG monitoring doesn't have any predictive value - it can only tell you that your baby is OK whilst you are strapped on. So if it's inconvienient to have it, or it's causing you stress, you don't have to have it. A better predictive test (though still not entirely accurate) is to have a doppler and ductous venousis scan - they use ultrasound to measure the blood flow through the umbilical cord and through the babies heart passages respectively. A sluggish flow may be an early indicator of problems.

If you are being induced at 36 weeks it is extremely unlikely that you will have any problems. I would reiterate teh suggestions to talk to Jenny - she is wonderful on a practical and emotional level. Good luck.

(HIJACK)
Amity - are you getting any treatment for the monthly itching? - I've had this since ds (my 2nd preg) but my last GP practcally told me it was phsychosomatic and said there was nothing they could do.

never mentioned it to gp. Just put up with it!
is there anything he can do?
will it get better over time (dd 21 months)?

Hello!

I have been itching since Saturday - hospital say blood tests clear (I'm 40+4 now) Should I be looking out for anything, if it is obstetric cholestasis and not just heat rash/streched skin?

A quick summary of symptoms:

There is no rash. Itching can be all over, but specifically the soles of the feet/palms of the hands are worst. You itch so bad it makes you want to chop them off! Itching is particularly bad at night. (I would be awake most of the night trying to stop the itching - cold baths helped!)

If your blood tests are clear, then you are unlikely to have the other symptoms, which can include jaundice, pale stools and dark urine (I never had any of these symptoms anyway!)

Do you have a rash? That can be a sign of PUPPS.

If you're 40+4, are they likely to induce you soon? Good luck anyhow!

Thanks

Think i'll be induced on 41+1 . I do have a rash - what is pupps?

Cheers

Helen

Here is a link, but I'll post what it says below:
\link{http://www.ivillage.co.uk/pregnancyandbaby/pregnancy/tri3/qas/0,,13_158400,00.html}

PUPP stands for pruritic (itch) urticarial (like ?hives?) papules (red pimples) and plaques (irritable flakes) of pregnancy. It is an annoying but benign condition. It is the most common skin condition of pregnancy and is characterised by a typical rash, usually appearing in the later part of pregnancy. It occurs in less than one person in a hundred. The rash usually develops on the abdomen near the umbilical area and spreads to the thighs and extremities. Sometimes itching can become very severe. It can spread to the rest of the body, but never involves the face. It is more common in first pregnancies and seldom recurs in subsequent pregnancies. This condition is usually a familial one and can be traced back through the father's side of the family.
Treatment can involve cortisone creams in the worst cases, but occasionally simple moisturising creams work. So can Calamine cream. Long, warm sodium bicarbonate baths can also be relieving. You may need to be treated with oral steroids if the itching becomes intense, but this is not often the case, and is certainly actively avoided. The lesions usually go away after giving birth. Your baby is not affected.

Thanks