*Please Read* Obstetric Cholestasis

[Jo]

Wow it sounds like you had quite a day
The good thing is they have finally diagnosed you, everything you have said sounds exactly like what they did when I was having Jack.

I would doubt that they would let you go beyond 37 weeks so prepare yourself for 2 steroid shots for babys lungs ( made my bum go numb )

I had to go out and get a few early baby clothes for Jack but not too many.

Good luck and my tip would be to take a magazine and a drink for when you are monitered, it can get very boring xx

 

[kaleidoscope]

oh blimey Pixie..the good news is you have been diagnosed so you will be carefully monitored and my understanding is that they dont let you go past 37 weeks..so best get everything ready!

My last lot of results a week ago came back normal so theyve said they wont re do them now as something would have shown up..not entirely convinced but ho hum..still itching and noticed my bed sheets were blood stained this morning where I have scratched my skin raw in the night

Im going in for 3x weekly CTG at the mo and it is mind numblingly boring! so I always take a snack, bottle of water and a mag..

 

[lauzliddle]

I thought I would update you on what happened to me yesterday.

Well my midwife came to my house yesterday afternoon for my check up. Everything was fine with my blood pressure, urine, etc. But after looking at my blood test results again she wasn't happy with them as they seemed a bit high, especially with all the symptoms i've been having. For over 2 weeks now i've been really itchy, off my food, being sick, had a show last weekend, and also had some pains on thursday night which were coming every 10 mins, but only lasting 2-3 seconds each (I now realise these were Braxton Hicks!) Also had reduced fetal movements past 2 days.

Anyway, my midwife made loads of calls to the hospital, and although they were full up in the fetal health unit, they agreed to give me a CTG on labour ward. I was told to go to pathology first and get some bloods done and also to take an overnight bag!

We got to Labour ward at about 4pm and was shown to a bed where we sat and waited til about 4:20pm before anyone came to see us. I was hooked up to the CTG machine where they measured the baby's heart rate and my uterous to see if it was contracting at all. I was supposed to be on the machne for half an hour, but it ended up over an hour!

Everything was fine with the baby and I wasn't having contractions which is great. But when the midwife spoke to the registrar she looked at my notes and my LFT's and confirmed I now DO have Obstetric Choleostasis, even though they told me last week I didn't have it. I have now got to take Vitamin K tablets every day, and they have also prescribed piriton, and calamine lotion to help with the itching. I've got to go back on monday for more blood tests, which will be sent to Birmingham for some reason(?!) I have to have 2 CTG's every week from now on, a growth scan of the baby and a scan of my liver too and blood tests every week to check my liver function.

I am hoping i'll be induced at 37 weeks as I don't want to risk stillbirth if left till full term (2 weeks time and on DH's Brother's birthday!!). I just hope it won't be at 38 weeks as that'll be my birthday!

I was home 3 hours later, so didn't need my hospital bag after all! Lol.

They measured my bump at the hospital and she's measuring quite big - 39cm! So not sure if I will need to buy any premature/early baby clothes. I have 3 early baby sleepsuits just in case. DH will have to go and buy more if we need them. I've been feeling the baby move much more since I had the CTG which is a good thing at least. I have just got to wait for the hospital to call me now when my prescription is in for the vitamin K, etc as the pharmacy closed before we left last night.

I hope everyone else gets on OK. xxx

Hi hun not sure how the registrar diagnosed OC just on LFT's as these can be raised for a number of reasons including just a viral infection.

I was induced at 38 weeks exactly when i had alfie due to OC.

I agree with the others to take a mag and drink when going for your ctg as it is so boring i had to go 3 times a week. on the plus side i got a scan every friday from 30 weeks until he was born

I hope the itching gets better the piriton really helped for me. When you are next at the hospital i would ask them about steroid injections as there is a risk of prem labour.

if you have any Q's please ask and i will try and help as i got very clued up on it when i found out i had it. Laura X

 

[Jchihuahua]

Sorry to hear you do have oc Pixie. Feel free to pm me or ask anything you might want to know as I became quite the expert when I had it in Dec. I had all the scans, loads of monitorings and seemingly endless blood tests too . I was induced at 38 weeks. I wanted to be induced earlier than that but they insisted on me getting to 38 weeks.

 

[Pixie81]

Thanks everyone.

lauzliddle, I did have several sets of blood test results and liver function tests for her to compare which have been taken over the past few weeks. I guess those and my other sympoms were enough for her to make a diagnosis. I'm sure she knows what she is talking about.

I'm a bit worried as I took my first vitamin K tablet this afternoon when hubby picked them up from the hospital for me and was sick half an hour later. Worried it won't have got into my system. Don't know what made me sick. It may have been the tablet; not sure. I'm not usually sick until the evening. I will have to keep an eye on it tomorrow to see if the same thing happens.

Does anyone know what the vitamin K tablet actually does? Is it for me or the baby? x

 

[kaleidoscope]

the vit k is for you hun as OC can mean that your blood doesnt clot so well

 

[lauzliddle]

Thanks everyone.

lauzliddle, I did have several sets of blood test results and liver function tests for her to compare which have been taken over the past few weeks. I guess those and my other sympoms were enough for her to make a diagnosis. I'm sure she knows what she is talking about.

I'm a bit worried as I took my first vitamin K tablet this afternoon when hubby picked them up from the hospital for me and was sick half an hour later. Worried it won't have got into my system. Don't know what made me sick. It may have been the tablet; not sure. I'm not usually sick until the evening. I will have to keep an eye on it tomorrow to see if the same thing happens.

Does anyone know what the vitamin K tablet actually does? Is it for me or the baby? x

I just found it strange that she diagnosed with just LFT you normally need bile acids to confirm and scan as the same symptoms arise in gallstones. And the vit k is for you so your blood clots properly. x

 

[Pixie81]

Thanks everyone.

lauzliddle, I did have several sets of blood test results and liver function tests for her to compare which have been taken over the past few weeks. I guess those and my other sympoms were enough for her to make a diagnosis. I'm sure she knows what she is talking about.

I'm a bit worried as I took my first vitamin K tablet this afternoon when hubby picked them up from the hospital for me and was sick half an hour later. Worried it won't have got into my system. Don't know what made me sick. It may have been the tablet; not sure. I'm not usually sick until the evening. I will have to keep an eye on it tomorrow to see if the same thing happens.

Does anyone know what the vitamin K tablet actually does? Is it for me or the baby? x

I just found it strange that she diagnosed with just LFT you normally need bile acids to confirm and scan as the same symptoms arise in gallstones. And the vit k is for you so your blood clots properly. x

I think those are the tests we're waiting for from Birmingham.

I have my growth scan and another CTG tomorrow so hopefully will have some more questions answered.

Do you think I might not have it then without these results? Thats concerning as they've already given me Vitamin K... could that harm the baby if i'm taking them if I don't have OC?

 

[lauzliddle]

hi hun just a little bit of how OC is diagnosed:
Your doctor will diagnose OC from blood tests called liver function tests (LFTs) and a serum bile acid test. They should also be keen to exclude all other possible causes of your itching, such as allergies or eczema.

Doctors may also take into consideration the following as evidence of OC:

pale stools
dark urine
a family history of OC
Liver function tests are performed to gain an idea how the different parts of your liver are functioning. They are made up of a number of separate examinations, each looking at different properties of your blood.

In OC, doctors will be looking for abnormal levels of the liver enzymes alanine aminotransferease (ALT), aspartarte aminotransferase (AST) and gamma glutamyl transferase (GGT).

The most specific test involves measuring serum bile acids. Usually the level of bile acids in your blood is raised before the liver function tests can detect any changes. If the tests are within normal limits and you carry on itching, it is important that the tests are repeated.

Unfortunately the serum bile acid test is not available in all hospitals. Your doctor may need to send a sample to a specialist centre for diagnosis.

If LFTs are abnormal, doctors will carry out screening to eliminate other causes such as viral hepatitis and autoimmune disease before diagnosing OC.

This may involve an ultrasound scan to look for any sign of liver abnormality. Doctors may also use ultrasound to check for gallstones, as research suggests these occur more often with OC.

If measured levels return to normal or increase rapidly, doctors may consider that you do not have OC.

Research suggests that absorption of vitamin K is reduced in OC. A lack of vitamin K may affect your blood’s clotting mechanism and increase blood loss during birth. Following diagnosis it is important to have a blood test to check how your blood is clotting before the birth as you may need extra vitamin K.

Your pregnancy may involve having regular tests to monitor your baby’s heartbeat over a set period of time (cardiotocography).

Im sure the vit K wont have any affect on the baby as it is for your blood and not the hers iykwim.
Try not to worry too much when the results come back from Birmingham you will know for sure if it is OC and you will be treated properly.
i was a little messed about by a midwife when i was first diagnosed who said the LFTs were only raised due to a 'viral infection' and what was i so worried about. Even though my mum had had a still birth at 38 weeks we didnt know she had the same condition until i had it and they got her notes out and confirmed thats what had caused the still birth.

 

[Pixie81]

hi hun just a little bit of how OC is diagnosed:
Your doctor will diagnose OC from blood tests called liver function tests (LFTs) and a serum bile acid test. They should also be keen to exclude all other possible causes of your itching, such as allergies or eczema.

Doctors may also take into consideration the following as evidence of OC:

pale stools I have these
dark urine and this and also loss of apetite, nausea and tiredness which I have also been told are symptoms
a family history of OC
Liver function tests are performed to gain an idea how the different parts of your liver are functioning. They are made up of a number of separate examinations, each looking at different properties of your blood. Had lots of these, and are due to have more tomorrow

In OC, doctors will be looking for abnormal levels of the liver enzymes alanine aminotransferease (ALT), aspartarte aminotransferase (AST) and gamma glutamyl transferase (GGT).

The most specific test involves measuring serum bile acids. Usually the level of bile acids in your blood is raised before the liver function tests can detect any changes. If the tests are within normal limits and you carry on itching, it is important that the tests are repeated.

Unfortunately the serum bile acid test is not available in all hospitals. Your doctor may need to send a sample to a specialist centre for diagnosis.

If LFTs are abnormal, doctors will carry out screening to eliminate other causes such as viral hepatitis and autoimmune disease before diagnosing OC.

This may involve an ultrasound scan to look for any sign of liver abnormality. Doctors may also use ultrasound to check for gallstones, as research suggests these occur more often with OC.

If measured levels return to normal or increase rapidly, doctors may consider that you do not have OC.

Research suggests that absorption of vitamin K is reduced in OC. A lack of vitamin K may affect your blood’s clotting mechanism and increase blood loss during birth. Following diagnosis it is important to have a blood test to check how your blood is clotting before the birth as you may need extra vitamin K.

Your pregnancy may involve having regular tests to monitor your baby’s heartbeat over a set period of time (cardiotocography).

Im sure the vit K wont have any affect on the baby as it is for your blood and not the hers iykwim.
Try not to worry too much when the results come back from Birmingham you will know for sure if it is OC and you will be treated properly.
i was a little messed about by a midwife when i was first diagnosed who said the LFTs were only raised due to a 'viral infection' and what was i so worried about. My midwife also confirmed I did not have it when the first set of results came back, despite the levels being high. They thought it was due to another liver problem I have. But when I saw her 2 weeks later and was still excessively itching and had all the other symptoms, thats when she said, this isn't right, and pushed the hospital to give me more tests... which is when I was told I had it. Even though my mum had had a still birth at 38 weeks we didnt know she had the same condition until i had it and they got her notes out and confirmed thats what had caused the still birth. So sorry to hear about that. It must've been awful.

.

 

[Jchihuahua]

Hope you're ok hun. To completely diagnose me they first did the bloods based on the symptoms I was having. My ALT and AST were raised and my bile acids were MASSIVELY abnormal which they said pointed to oc but they did not make an actual diagnosis of oc until they'd ruled out anything else it could possibly be. They did a load of blood tests for hepatitis and many other things that could affect my liver. They all came back clear but they still didn't make the oc diagnosis until I'd had a liver scan to confirm I didn't have anything else wrong with my liver. They started me on the vit k, piraton and tablets to bring my bile acids down (12 tablets a day!!) as soon as I had the initial abnormal blood results. While I was waiting for the official diagnosis they monitored us every 2 days and then once they had the official diagnosis was when they gave us the date for the induction.

 

[Pixie81]

Well I will see what they say tomorrow. Should have all the test results back by then hopefully. You guys have been great, thank you so much for all the advice, but I will go by whatever my doctor says. x

 

[Pixie81]

Hi Ladies, well i'm back after a very long and tiring day.

Went to Kettering for my growth scan with my DH this morning. It was lovely seeing our little girl again. We did ask for the sex to be confirmed one more time, just to be on the safe side, so I think its safe to say we're still on team pink, as this is the fourth time we've been told its a girl now. All her measurements were perfect and her estimated weight at the moment is 5lb 5oz. (How do they do that?? Technology nowdays!)

I had to go and have more bloods done which was a bit scary. They wanted me tested for so many things that I would've had to have 10 tubes taken. But after the nurse asked someone in haematology, it turned out I could just have 3 tubes taken and they could be split up when being tested... so that was a weight off my shoulders. I already had 5 tubes taken on friday! So that was over fairly quickly and was virtually painless.

Then we went to Asda and got some food shopping and I bought Mother and Baby magazine to read at my next appointment. Came home for a bit and I tried to eat some lunch (Plum Tomato and Basil soup) but it gave me indegestion so I only managed a few mouthfuls. Then I fell asleep on the sofa for an hour.

Then we picked up DS early from school and went all the way back to Kettering for my CTG at the fetal health unit. They got my blood test results back and found that my bile acid count is very high, so I definately do have Obstetric Choleostsis.

They've put me on ursodeoxycholic acid tablets that I have to take twice a day which should help with the itching and gave me some more vitamin K tablets which should last me until the end of the pregnancy. Then I have to go back on Friday for another CTG and again on Tuesday for more blood tests, a doppler scan and another CTG. I will have to have a scan every 2 weeks, bloods every week and a CTG twice a week. And then I will be induced at 38 weeks - which works out on MY birthday!!! Not sure whether I should make them change the date if they say it'll be this date, or actually give birth on my birthday.

From there I went to the car where I waited with DS while my DH went to the pharmacy to collect my prescription. My chest had felt like it was on fire since I was having my CTG and I knew I needed to get some milk fast...or I would be sick (its the only thing that helps my acid indigestion); but all I had was orange squash which made it worse. I opened the window to try and get some air but it didn't work and..... whoosh... all out the car window! Sorry! TMI! It was horrible. I tried drinking a bit more orange when I thought it was all up, but then I got a massive cough and loads of this thick stringy acid bile stuff came up. It was so scary. Has anyone else had this? Do you think its anything to do with the choleostasis? I will have to ask on friday. It was awful though. I've never had it like that before. I know the bile salts leak into your blood... but surely not your chest?


I've worked out i'm going to work the rest of this week and next week and then thats it. I can't believe its all happening so quickly! I'm going to be a mummy again very soon! I can't wait to hold her in my arms and cuddle her! I just hope she's OK.

 

[Jchihuahua]

Now you've been diagnosed the meds will certainly help with your itching hun. All the things they're going to do is the same as what I had and being so closely monitored made me feel better about everything.

One thing I'd say though is when you're induced early don't necessarily expect that you'll give birth that same day. I was induced at 38 weeks exactly and as my cervix wasn't ready yet it took 4 days in hospital post-induction before I was dilated enough to break my waters and then actually start proper labour.

 

[Pixie81]

Now you've been diagnosed the meds will certainly help with your itching hun. All the things they're going to do is the same as what I had and being so closely monitored made me feel better about everything.

One thing I'd say though is when you're induced early don't necessarily expect that you'll give birth that same day. I was induced at 38 weeks exactly and as my cervix wasn't ready yet it took 4 days in hospital post-induction before I was dilated enough to break my waters and then actually start proper labour.

Yeah, I was thinking that too. So if I am induced on my birthday, I won't nessesarily(sp) give birth on that day. I had a long labour with my first son. I know they say the second is usually quicker, but I had my DS 10 years ago, so not sure if that theory will work!

The midwife said I'll be induced with a pessary, although they might start me off with a couple of stretch and sweeps a week or so before. Something else to research! Lol.

 

[Jchihuahua]

I was induced with the pessary too so if you want to know anything just ask .

 

[Pixie81]

I was induced with the pessary too so if you want to know anything just ask .

Any info would be great! Thank you. xxx

 

[mummy2be2010]

hey mummys and mummys to be

im 18 and pregnant with my first

i got diognosed with Oc when i was 30 weeks, i had intense itching on my hands and feet my bloods were 136 (consultant told me it was that high), they didnt really tell me that i had OC untill at 33 weeks i asked them whet i was being monitered twice a week and why i had to have my bloods taken once a week, thats when they told me my bloods where high and they gave me a information leaflet on OC,

before they gave me the infomation leaflet, i had been on OC suport groups on the internet and other mums to be were getting induced at 37-38 weeks due to the risk of the baby,

i went to see the consultant and she then told me that my bloods were high, there is a risk to the baby even though there not sure how hig the risk is and before they used to induce so theres a smaller risk to the baby and she want me to be seen at my antnatial day unit twice a week for monitering and to have my bloods taken, so i went to make an appointment at the reception to see my consultant in 2 weeks and the receptionist told me my consultant wasnt there untill 5 weeks time and i was only aloud to see that consultant,

then the next time i went and got monitered the midwife told me my i would only have to come in once a week to be monitered as they had a big meeting about OC and they were looking into the sweedish rules on OC and because there is more common they are changing there rules on OC!!

i got monitered about a week ad half ago and spoke to the midwife on the antinatal day unit that i was concerned now i hadnt seen a consultant for about 3 weeks and its not fair on me and my baby waiting 5 weeks when im suposed to be seen every 2 weeks! the midwife agreeded with me and made me an appointment to see my conultant (even though the receptionist told me she wasnt in)

last sunday b4 my consultant appointment they rang me up and told me my consultant appointment had been canclled and they would ring me up to arange another one with my consultant as i wasnt aloud to see a diffrent consultan, i didnt get a phone call the next day so i rang them the midwife, and she said come in to get monitered and have my bloods taken and she would sort it when im there,

so i got monitered and the midwife told me my bloods have come down and she had made me a consultant appointement with a nother consultant and there they would disscuss with me a plan!!! to witch im now cofused as im in understanding my baby is at risk due to OC but they dont really like to offer induction, but i fill for the saftey of my baby i would like to be induced so i no my baby will be at less chance of risk than going full term!

i just fill like my hospital is messing me aboout and laughing behind my back!



xx

i went in

 

[Pixie81]

Mummy2b2010, I think it is absoutely terrible the way they are treating you and keeping you in the dark about this very serious condition. I would insist that you see a consultant ASAP. Although to be honest, although I have seen a seperate consultant for OC, the midwives and the doctor I have seen at the hospital when having my CTG's have been far more informative and have been looking after me really well. They are the ones that told me I would be induced and told me all about the symptoms, etc. Can your midwives not make more appointments for you to be monitored? I have to go twice a week; on a Tuesday and Friday. I have to have a CTG twice a week, bloods once a week and a scan/dopler scans on alternative weeks. I feel I am being well looked after and definately think they should be doing the same for you. I would definately have a chat to your midwife hun and tell her you're not happy. x

PS. Just realised we're due the same day and we don't live that far away from each other either! x

 

[poppykat]

Been diagnosed with OC today after a weekend of intense itching on my hands, feet, arms and legs Got to go back tomorrow to get medication (pharmacy at hospital is not open on bank holidays ) and they will book liver scan and growth scan for baby and appointment with consultant. They said they will probably induce me about 37-38 weeks too.

Feeling quite down about it all and find it all hard to take in. So if any of you lovely ladies have any extra info or insight into what is to come for me I would really appreciate it xxx