*Please Read* Obstetric Cholestasis

[SurpriseBub]

It sounds like you both are getting great care, which is wonderful. wishing you lots of luck

 

[sherylb]

Ugh. It's 3am and this itching will not stop. I haven't gotten any sleep. I sent a message to the doctor I saw yesterday and will see again Friday to ask her to look into switching me to Urso to help with bile acids and itching. Welchol isn't helping itching at all.

 

[sherylb]

This doctor seems confused. Labcorp posted my results today except for the bile. I know the bile was 18. Her reference range went to 21. I know diagnosis is usually for above 10. My alt Friday was 74, normal being up to 32. Ast is 39, normal up to 40. Alkaline phosphatase S (whatever that is) is 183, normal being to 117. My protein serum was under range which seems crazy because I consider myself to have a high protein diet but I know my iron was low and I have been put on an iron supplement too as of yesterday.

She told me my biles were high normal but everything else was basically normal... my normal doctor is on vacation all week. She said they were still trying to determine if I had ICP and I had fresh bloodwork taken yesterday.

 

[Sophiasmom]

So sorry I'm right there with you. I've been told that Urso won't necessarily take away itching either, but at least it's more protection for LO. Also, from what I remember reading, meds like cholestid and welchol can worsen the Vitamin K deficiency that comes w ICP and put you at higher risk for pph. Even though Urso isn't approved for pregnancy, it seems to be the best option.

 

[Sophiasmom]

I just read your latest post. That stinks. That's also why the BA level is the primary lab value for diagnosing ICP. AST/ALT "normal" range for pregnancy is lower than a non pregnant person, so yours are definitely elevated. Alk phos levels rise in 3rd trimester anyway (from the placenta), but again, yours is elevated. I really think they could confirm your diagnosis with symptoms and LFTS. Hopefully this next set will be back quickly and your doc will be back in town

 

[sherylb]

Ok so.... I got my blood drawn. My new results shouldn't be ready until early next week. The maternal fetal medicine specialist can't get me in until the 1st and I may well have a baby by then. The doctor I have seen this week said she did the best she could to get me in there but they will consult the other doctor as needed and continue to monitor me with sonograms and bloodwork. My part on my new prescription was $550 but this helps the bile stay away from baby, reduces the bile and helps with my itching. My other medicine didn't do anything for me and was apparently a mistake made in haste without research.


I think my visits and sonos will continue to be Tuesdays and Fridays until Emmitt is here.

 

[sherylb]

I was admitted to the hospital a week ago for observation because my test results jumped so much the doctor wanted to rule out preclampsia and get the MFMs to see me right away. I'm 36+1 now and my doctor plans to induce Thursday at 37+0 if he isn't here on his own. I'll be at the hospital 2 weeks then already. They are doing my liver function tests daily and baby is monitored 30 minutes every 8 hours. Bpps Tuesday and Friday. I'm allowed to walk 2 hours a day since I'm not hooked up to anything but confined to labor and delivery so I won't be somewhere like outside alone when I go into labor. The doctors are being very cautious since they haven't had a cholestasis patient from what I gather. My last bile acids were taken on Wednesday and took until Tuesday to come back so they are judging his safety on just liver function tests now. If they are the least bit concerned they will induce right away.

 

[Sophiasmom]

Oh my gosh! We'll I'm glad they're taking everything seriously and keeping a close eye on you and LO. Sorry you're stuck in the hospital in the meantime. I hope the next week goes quickly and smoothly for you!!

 

[Sophiasmom]

I hope all went well with your induction and you and your LO are doing well!!

 

[sherylb]

I actually ended up going into labor on my own at 36+4 on 8/31. He weighed a pound more than we expected and labor was only 2 hours from the doctor checking me for change and breaking my water at 5cm. DH barely made it. I already had my epidural when he got there from work 30 minutes away. We are both doing really well. He didn't need any assistance. 7lb 3oz.

 

[Sophiasmom]

Oh that's so great!! Glad your hubby was able to make it! My DH has a business trip the week before I'm scheduled for CS, and I've been having so many strong contractions lately I'm feeling like labor may start on its own. Really hoping he doesn't miss it!

So glad you guys are doing well!!

 

[mumziemcvoy]

Hello everyone I have been diagnosed today at 34 weeks with oc my bile acids 16 and alts 113 .. Had oc in my last pregnancy as well was induced at 37 weeks but that failed so had a c section she's now a happy healthy 2.5 year old

 

[Sophiasmom]

Are you going to be induced at 37 weeks?

 

[mumziemcvoy]

I'm not too sure I was last time but this time she said we will get you as far along as we can ?? But doesn't the risk go up lots after 37 weeks I thought that was the standard plan for cholestasis x

 

[Sophiasmom]

Yes, the risks are higher after 37 weeks. I had ds1 at 37w5d but I was a late diagnosis last time. I am 36w2d and just now officially diagnosed with ICP. I've been itching since 26ish weeks but labs are just now reflecting the ICP. I've been on Urso for symptomatic treatment since early August. CS is scheduled for Monday (37w1d)

 

[mumziemcvoy]

How exciting not long to go
Now am seeing consultant on Monday and I'm pretty sure it will
Be 37
Weeks for me well I hope
So as I know the risk increases after that

 

[kmr1763]

So I had this last pregnancy and have felt mildly itchy the past few days so went to get blood test today.
Going through my old labs, the only test that I see that has to do with OC is alkaline phosphate, which I also read can be elevated in pregnancy. Last pregnancy it got up to like 290 or so, and at my 28 week appointment it was up in the 160s but no one mentioned anything to me. Anyway, I can't find anything else that indicates OC unless it's labwork I don't have access to. Is alkaline phosphate enough to diagnose OC?

 

[MemmaJ]

Alkaline phosphate is always elevated in pregnancy, it's usually raised Bile Acids that primarily diagnose OC - was that one of them?

 

[kmr1763]

I know it's always elevated, and actually found a normal range for each trimester. But other than that one I can't find labs for anything else related... Unless I'm just not seeing them or don't have access to view them... But I will check again!

 

[kmr1763]

Oh I totally found it! Although both results from prior pregnancy look in range so I'm confused. But again, maybe I'm just not seeing it right! I'll wait impatiently for the results. Really hoping to not be induced this time!!!