*Please Read* Obstetric Cholestasis

[RinnaRoo]

Hey Kittycakes, that's where all of my itchy was. The tops of hands, feet, ankles, and on the heel. My blood bile levels have all come back well within a normal range, but I had a blood panel done, and my kidney levels are off, but only by 1 or 2 points. Im not 100% sure whats doing on. My feet and hands have become increasingly LESS itchy over the last two days.
I feel like if youre 37 weeks now, the levels would have been at their highest. Ask your OB about any other tests or symptoms that you need to be on the look out for.

 

[MrsItchy]

Hi there

Im new here and saw this post and had to respond!

I hate the way I have been treated in the past with this condition, with my son they would not acknowledge it at all despite my levels being abnormal. I was refused medication and luckily my son was ok, he was induced for supposedly cholestasis but the main reason being calcifying placenta (which I found out could have been because of icp)

I am 34 weeks and have cholestasis now. My bile acids were 18.7 on Friday, 61.2 on Sunday and 75.8 as of yesterday depite being on Urso. They have upped my dosage to 1500mg from 1000mg. I really feel there isn't enough professionals who know enough about this. I spoke to one midwife yesterday in training and she said she's never seen it and she's been training for 4 years!

 

[GdaneMom4now]

Hey girls, I was diagnosed with OC a few weeks ago (after fighting for the test) and they put me on urso. I'm having weekly ultrasounds to check on babies, and scheduled for csection on August 11 (37 weeks) is that early enough for twins? I didn't know if it was any different for twins vs singleton pregnancies. They said they won't be rechecking blood unless my symptoms get worse. I'm on urso 500mg twice a day.

 

[Buttons_01]

I had a midwife appointment yesterday and mentioned to her that i was having itchy hands and feet especially at night.. She took my bloods and said i would get the results that evening. I got a phone call about 6 oclock and they said that my levels were slightly raised but didn't give a number. She also didn't say what was raised just that it is something to do with my liver. She asked an obstetrician(?) i think if i should go in or not but apparently he wasn't too concerned and i am too wait a phone call on Monday to arrange for more bloods to be taken. I am 38 weeks today and although they said they aren't worried i am.
i don't want to google things because it might be nothing and i find google makes things worse. I was wondering whether i should wait until my next appointment for more bloods or phone up and ask for advice? .. I don't like pestering people if its nothing to worry about. Also with it being a Saturday my doctors surgery is closed so i was wondering whether you can phone the community midwives for help? Or should i just wait?

 

[NeicyRTB]

I began itching all over pretty intensely a few days ago, the day before I turned 34 weeks. I experienced some itching before but never thought of it to be anything until a few days ago when the itching became so bad I literally felt like I would scratch my skin off. I saw my doc yesterday and am waiting on lab results. They are trying to rule out cholestasis.

Update: results came in all normal but itching seems to be getting worse. hmmmm
I was told that if the itching continues they will retest labs in a week or so.

 

[Wtbam]

Hi Ladies

I have been diagnosed with OC today at 34+1. I had bloods done 2 weeks ago due to itchy hands and feet but they came back fine, and bloods yesterday due to now itching all over have come back with raised bile acids (28) and raised liver function (sorry don't have my notes to hand).

Results came back this morning and spent the day at the hospital today, they seem to be taking it quite seriously which is reassuring.

Anyway, I have a few questions.

I have been prescribed Urso, but only 300mg per day. This seems to be a lot less than other people! Is this because I only have OC midly or for some other reason?

I have been told I will be induced 1-2 weeks early but most people on this thread seem to be induced at 37 weeks. What is the protocol for this?

It was mentioned today that there is a small increased risk of stillbirth due to OC. What is the actual REASON for the stillbirth?

Thanks in advance

 

[Incubus]

Hi Ladies

I have been diagnosed with OC today at 34+1. I had bloods done 2 weeks ago due to itchy hands and feet but they came back fine, and bloods yesterday due to now itching all over have come back with raised bile acids (28) and raised liver function (sorry don't have my notes to hand).

Results came back this morning and spent the day at the hospital today, they seem to be taking it quite seriously which is reassuring.

Anyway, I have a few questions.

I have been prescribed Urso, but only 300mg per day. This seems to be a lot less than other people! Is this because I only have OC midly or for some other reason?

I have been told I will be induced 1-2 weeks early but most people on this thread seem to be induced at 37 weeks. What is the protocol for this?

It was mentioned today that there is a small increased risk of stillbirth due to OC. What is the actual REASON for the stillbirth?

Thanks in advance

Research actually now suggests that there is no increased risk and it is the same risk as someone without oc, I did a lot of research when I was diagnosed

I wasn't induced either, urso kept my levels pretty stable so they put off the induction until 40 weeks but waters broke naturally at 38+4 and I had a quick, easy natural labour. But I did have a bad urine infection which may of been what triggered my labour!

Have they given you antihistamines to help with the itching? X

 

[Wtbam]

yes but i haven't taken them yet as it is mamageable with cream/cool baths!

Thanks..... the thought of stillbirth makes me VERY nervous so I am panicking a lot at the moment!

 

[GdaneMom4now]

Meconium is the reason for still birth. They took my twins at 36+1 due to it. The latest they were going to let me go was 37 weeks. But usually it's 38 for single pregnancies

 

[Wtbam]

I have a consultant appointment on weds but I have been doing a lot of research tonight and frankly been scaring myself silly.

The main thing I am concerned about are the risk of stillbirth (I now know due to the increased bile acids possibly affecting the heart rhythm, or the fact that meconium is released too early). Those that are UK based - could you insist on induction at 37 weeks and no later? Could you insist on having your waters checked for meconium before induction?

Also, was how itchy you were directly related to your bloods (do you know?) What were your blood results if you don't mind sharing? Did they get progressively worse as your pregnancy continued?

 

[MissMummyMoo]

Wtbam please try not to worry. As long as your results are being monitored and controlled as well as possbile the risk is reduced significantly. Not a lot is really known as OC.

You could ask for induction earlier but I don't think many like to risk it any earlier as even at 37 weeks a lot of problems can still occur. I was induced at 37+2 (due to severe SPD not OC) and my LO and I had to stay in an extra day as he couldn't regulate his temperature because he was basically forced out iykwim?

At their highest my bile acids were 166 and ALT 77. After taking Urso for a while they eventually settled around 13 and 10 I think x

 

[Tashiee]

Good morning,

Just wondering how long it took for your LFT's to return to normal. My ALT was just over 800 at diagnosis and 5 months post partum is still elevated at 92. I am waiting to see a hepatologist, but wondering if anyone's LFT has taken long to return to normal without having any secondary issues?

Thanks

 

[DebbieF]

I posted this in the same thread on 2nd tri as I am only 18 weeks. I thought maybe I would get more responses over here as this happens mostly to ladies in the 3rd tri..

Well, I went to see the doctor yesterday and she did the liver function test and the bile acid test. She called me earlier today with my liver function numbers..



ALT is 201 (normal range is 0-31)

AST is 86 (normal is 0-32)

Bilirubin levels were normal at .2



I wont get the bile acid results until next week. Based on these numbers is it likely I will be diagnosed with cholestasis? I'm pretty concerned about this right now and could use someone to talk to..

 

[Becka79]

I posted this in the same thread on 2nd tri as I am only 18 weeks. I thought maybe I would get more responses over here as this happens mostly to ladies in the 3rd tri..

Well, I went to see the doctor yesterday and she did the liver function test and the bile acid test. She called me earlier today with my liver function numbers..



ALT is 201 (normal range is 0-31)

AST is 86 (normal is 0-32)

Bilirubin levels were normal at .2



I wont get the bile acid results until next week. Based on these numbers is it likely I will be diagnosed with cholestasis? I'm pretty concerned about this right now and could use someone to talk to..

Hi Debbie, how did you go with the results? Have you had OC in prev pregnancies?

I had LFTs and they were normal but My obstetrician also tested the bile acid levels so I get those results on the 29th. I really hope I dont have this but the itching on my palms and soles of feet is very worrying!

 

[GdaneMom4now]

Yea you more than likely will be diagnosed. They'll put you on medication and closely monitor you. Search for groups on Facebook. That's where I got most of my info

 

[DebbieF]

Quick update. No official diagnosis yet, but the doctor put me on 300mg of Urso 2x a day. I started it Friday night, and so far it hasn't helped the itch at all. I will be 21 weeks tomorrow. If this doesn't help the itch, I don't know how I will be able to stand this until delivery.

Did not have this in my last pregnancy. If I would have, I would have never gotten pregnant again..

 

[GdaneMom4now]

It is beyond horrible. You quickly forget once they are born though. I cried many tears due to obstetric cholestasis. I took lots of cold showers, slept with ice packs, kept my house insanely cold, put my feet on buckets of ice water, hubby massaged my hands and feet. I hope you find relief in some of those things urso helped a little but not a whole lot. some girls it helps, some it doesn't

 

[Becka79]

My bile acid levels came back today, doc said they are 'well within normal range'.

I just want to know why Im itching specifically on my palms & soles of feet with no rash.. He suggested antihistamines but said it would be worth retesting if itchiness continues or gets worse.

Debbie have you tried antihistamines? Hope youre doing ok!

 

[GdaneMom4now]

Get them checked in a week or so if you're still itching.

Antihistamines do nothing for cholestasis

 

[Sophiasmom]

Your levels may not have risen yet. I agree they need to keep checking if you're itching. I had itchung for a couple months before it got insanely bad around 36 weeks. Cold showers and ice packs were the only way I could get some rest. Basically my levels were normal until they skyrocketed. I had to deliver DS early by CS. And I agree- antihistamines do not help bc the itching isn't from a histamine response. Good luck!