sophable has obstetric cholestasis, please tell me about induction...

[Heathcliffscathy]

almost certainly have it liver results and itching indicate. liver scan tomorrow.

shite and fuck

i think this means no homebirth (absolutely gutted, not because i'm a lentil quiche wearer but because i do not feel safe in hospitals).

i'd really really appreciate any info you have on this and even more so any info about induction...is there ever a great outcome birth and breastfeeding wise???

if they do this at between 36 and 37 weeks it's going to be nightmarish isn't it and prob end up in c-section.

any help gratefully received, mars, mears, anyone else at all, i really need all the info i can get.

gutted gutted gutted

sophable, I was induced all 3 times, and DD2 was induced at 35+2. Prostin pessary at around 10 am, waters broken at 5 pm, labour with gas& air and Pethidine. No synto. 5 minute pushing stage, and DD2 was born at 01.00.

Honestly not a bad labour at all, and I was flat on my back from 7pm until 1am because I am a wuss, and pethidine knocked me flat!!

thank you all so much. fuck. i'm just so sad that this probably means I can't do it at home, and I'm so scared of effects on baby of this condition (higher risk of heart arythmia as far as I can gather).

really wonderful that you're all posting. the more information I have the better I feel tbh.

Oh and another thing - avoid opiates if you can because they slow down the contractions (or so I was told).

Hope all this is giving you hope - it will be ok! You will have a lovely baby and everything will be OK and when you are (like me) 6 and a half years down the line you won't care how/where you birthed, you will just have lovely soft 6-year old cuddles and be glad that you did!

I'm prolific tonight!

Also, I know what it is like to worry about what the effect of your condition will be on your baby. I was told IUGR (though it didn't happen, she was 7lb15 which was teeny compared to the other two but a great weight!) due to stress and pain, and possible withdrawal symptoms (as I had been on some very very strong analgesia during pregnancy) and when I had some contractions at 35 weeks I got flown to a big hospital with a SCBU (lived on remote scottish island at the time).

Don't panic!! Its horrible worrying about it all, but there's no reason that everything shouldn't be just fine.

I had OC with both of mine. One induced at 37 weeks (epidural - take it if you can!), the other at 36. First weighed 7lb 2, second 7lb, both healthy.

Bit late to post more, but am happy to advise. Can also recommend the OC support line - which is also on FB!

I was induced at 42 weeks. Straightforward, no problems except that it really hurt but no surprise there. SIL induced at 37 weeks (with twins for IUGR) no problems, quite quick, paracetamol only. Its not necessarily awful to be induced. Good Luck.

ooo mary, i've found the oc support website, and forum. will look on facebook

bump for daytime lot.

going for liver ultrasound today so no food from 8, had to force oats and yoghurt down (i'm not a bit morning eater) yuck.

bile bloods should be back today so will probably get a definitive diagnosis although i think there is little doubt unless unbeknownst to me i've had hepatitis for ages!!!

ive had 4 inductions at (1 at)38 and 36 weeks.

All svd.

The labors have been long-20-36 hours.
1 birth didnt require any pain relief at all,
1 and epidural-all though too late to have any effect.
1 gas and air
1 morphine (another story all together)

The births have become progressivly harder each time, and when the drip is in the contractions are intense.
but labour is hard and contractions are intense!

tbh I am of the opinion that it is such a short thing to go through in the scheme of things-and getting a baby at the end of it is all that matters really.

Sophable, I was induced with DD3 at 40 weeks, due to her health problems rather than mine. As I have had a previous section, it went straight to a synto drip, so I had an epidural. It was by far the best of my three births - I dozed through the contractions, then woke up and told the mw that I could feel some pressure and thought I was ready to push. She agreed, DD3 was born about 1.5 hours later. The MW delivered her head, then I caught her under her arms and brought her out the rest of the way myself. 'Twas just fabulous .

She bfed very quickly, but then was in SCBU for 5 days, where she was tubefed. Expressed for that time, then bfed her with no problems till she was 14 months old.

I hope it all goes as well for you.

Sophable - I had OC and had to have ds at 37 weeks and was on valium at the end for the itching. They persuaded me to be induced and I had the drip which meant I went straight into quite powerful contractions. However, I had arranged with the consultant beforehand to have a caesarian if I wished, so I had that (really don't like pain) and it went very smoothly.

DS had to go into special care for around 3 hours (breathing), but I had lots of tea, got down there in a wheelchair and breastfed when he came out. It was all absolutely fine.

No experience of OC myself but a good friend had been induced twice because of it.

First was at 37 weeks, just the pessary (6 and a half pounds baby) and second was at 36 weeks, pessary and the drip (8 and a half pounds baby).

Both times mum and babies were fine and babies were both breast fed from the start (and for quite a while too). They didn't need any extra care from scbu either. But because they were classed as early babies they did have to spend a few days in hospital.

Good luck.

I'm not sure if being very overdue/not quite due really has an effect on whether induction works and how well, to be honest.

37 weeks is term, so anything after that means the baby is effectively fully developed and ready to be born. I went to 42+5 with my first baby and still had a long, failed induction where I only dilated to 2cm, which just goes to show...

In other words, just because you are induced slightly early doesn't mean it is much less likely to work. Induction is induction - it's the artificial bringing on of labour, whenever it takes place.

Sophable - i had quite bad Cholestasis. I wasn't induced - i was booked for a section at 38weeks but DS3 was born 2 days before section was due.

How many weeks are you? I had a liver scan but i don't remember having to fast for it. ANd from the day they confirmed OC i was in hospital every other for either bloods or monitoring (or both). I was allowed home in between because i had the other 2 DCs to look after but they really wanted me in as they didn't have a lot of experience of levels as high as i had and with the placenta problems i had (placenta previa)
I was on Urso (but i can't recall the long name for it sorry!) and was given piriton each time i was in hosp. Was admitted overnight a few times when my levels rocketed even more but sent home the next day as no one seemed to know what to do with me!

I too wanted a homebirth but couldn't

The itching stopped the second that DS3 was born - literally! and my follow up bloods came back all clear. DS3 was fine, no issues with him not even newborn jaundice!

I was induced at 38 weeks with my first baby. I had a pessary about midday on the Thursday. Another one at midnight. AROM around midday on the Friday after 'tightenings' had started. Baby born around 5pm. I used Entonox only as pain relief. I did walk around a lot, probably until about 2pm.

As you know I had a failed induction (5 days of the pessaries and then ARM,then syntocin etc then c-section due to failure to progress.)

If I could do it again, knowing what I know, I would have not let them keep on with the pessaries as the prolonged period of induction was the reason for my massive PPH. I was desparate not to have a c-section (more due to squeamishness than lentil weaveryness) so I let them carry on in the hope that eventually I would manage it and my uterus then would not contract as it was floppy from all the contractions (which I couldn't really feel but showed up on the trace). (I'm sure you know all this but I thought I would put it on here too with the rest.)

So sorry if it is and you can't have your HB

How would you feel about a c-section rather than an induction?

I wish I had gone straight for one before but it is easy to say that with hindsight isn't it ? At the time it was really a last resort in my mind and I would absolutely have turned it down had it been offered earlier.

I wonder if inductions are in some way more successful or easier if you have already had a vaginal birth

OK can I tell you what happened to me in hospital today?

I had an appt at 1pm, was told to fast from 8am for a scan at 2pm.

I waited 40 minutes. My indep midwife wanted to come with me but got stuck in horrendous traffic and was late. went in to have blood taken. asked for a print out of the two sets of bloods they have done. they said they couldn't give them to me, but would print them out and a midwife could decide whether to give them to me (!!!!) She then didn't know which vials which bloods went in (!) so left to phone and ask (!). I promptly put my blood printouts into my notes.

all this crap made me late for my liver scan. I waited there another 40 minutes. The scan was all fine.

In the meantime my IM arrived with a sheaf of evidence about OC including the royal college of obstetrician and gynaecologists summary. In short there is NO evidence for early induction. I'll repeat that, according to the governing body there is no evidence for early induction and in fact as the research into the condition gets more recent (from the 70s forward) the rates of stillbirth go down until they are comparable to the general population. Good news you might think if we lived in any kind of sane world.

So then I go back to day assessment unit - do they want to talk to me (so far they have run blood tests but no one has actually spoken to me about anything).

yes i need to speak to a dr, but they are all in theatre so i need to wait. so I wait for another hour. I'm keeling over by this point, and need to go pick up ds, so I pop my head round and say i'm going. No you don't they say, you need to speak to a dr. I said but all the blood results won't be back until tomorrow, so they won't have the whole picture and also can he not phone me?

so they make me sign a discharge form because i'm going against their advice, and the midwife says that one of my liver results is off the scale high and she doesn't want to frighten me but i need to speak to my doctor.

so 2 hours later (i'm at home) said consultant phones me to inform me that OC is a diagnosis made by ruling other conditions out so i will need a liver scan. I've had one I reply and it was all clear (according to the scanner). oh good he says. well you need to come in to see consultant on monday as you probably have OC and as you know that will affect your baby (based on NO evidence) and the only 'cure' is delivery, but obviously we have to balance that against the fact that you are only 34 weeks. right I say, Monday. OK. just one last thing, what about this very raised result, should I be concerned like the midwife suggested. Yes this implies LIVER FAILURE he says.

right so how come I'm waiting until Monday? because that is when your consultant is in. But what you've said has really scared me...yes it is frightening he replies. so monday at 3? yes.

FUCKING WANKER.

What a pile of total and utter shit. the protocols are Not evidence based but of course they ahve managed to really scare me.

What a nightmare sophable. Did your indep midwife have any useful input?

IM gave me all the evidence, told me and dh to read it and said there was no reason for early induction or hospital birth based on current evidence.

that is NOT what the consultant will say on monday guaranteed.

Oh no, sophable. That sounds like a shitty day, alright. I hope Monday brings better news.

Same here, I meant to reply before, but wasn't sure what to say. Is IM your midwife? I hope this weekend hasn't been too bad for you, and you get answers tomorrow.

Personally, I'd check out anything the IM says with the OC support line. I remember being fed all sorts of crap by so-called professionals - but in the end, I knew far more than they did. I remember my consultant being really impressed though, he used to get me to explain the condition to visiting Drs and senior house doctors!

Soph, I know a really good Obstetricain in Harley Street who says it like it is (he was in the Guardian this week - he is a fertitlity expert) Happy to give you his nnumber if you feel you need an outside opinion.

I don't understand the liver failure bit - I thought you siad liver scan was clear?

How did Monday go? How are you now? Have been thinking of you...

Mary, my experience mirrors yours.

Monday was awful, in that the consultant at kingston wanted to induce this week (34 weeks).

I went to see the lead researcher on the condition and have had several conversations with the lady that runs the OC support group (they are both fabulous).

whilst my bloods are pretty shit in that my readings are very high even for OC, they have given me the information to conclude that the best policy is careful monitoring of my bloods and making a decision on that basis. I'm on Urso now and that needs another couple of days to work, I will test again beginning next week, if levels still really high, need to make a decision if not then can continue monitoring but not past 37-38 weeks.

have registered with St George's because they have the best neonatal unit in the SE and there is an increased chance of early labour.

feeling overwhelmed with it all, and baby is quiet today which makes me totally paranoid.

If you're at all worried about movement, phone them up and get them to monitor. Never be afraid of being a nuisance, because "the other" would be unthinkable.

I got involved in the research programme too, and they were wonderful. Is it Catherine and Jenny you're referring to? Say hi to Jenny from me, if you speak to her!