I went to the doctor who said she thought maybe it was an allergic reaction to something. It is more common in certain ethnic groups, particularly those from South Asian, South American, Nordic and Scandinavian regions, and has a familial and genetic basis. The symptoms get better when your baby has been born. Cholestasis is more common in the last trimester of pregnancy when hormones are at their peak, but it … Really hope you haven't got this - but as has been said no reason to worry at this stage even if you have. All twin pregnancies delivered above 28 gestational weeks in West China Second University Hospital from January 2013 to May 2015 were included. 2013 Jun 24;2013(6):CD000493. Occasionally it happens in the late second trimester, but it doesn't occur before 20 weeks. But the birth was OK, and all the liver function measures went back to normally pretty quickly afterwards. Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC), is a liver disorder that can develop during pregnancy. I believe it can even start as early as the second trimester. Too much reading about pregnancy related problems is definitely bad for one's health! BJOG. If you do have OC they shouldn't be making you wait a week for an induction. (after months of discomfort) Anyway, glad you don't have to go through that. To comment on this thread you need to create a Mumsnet account. And Urso would take more than a couple of days to have any effect on the itching (if then). Don't accept that. if it turns out not to be OC, i recommend aqueous cream (available from pharmacies). Find out what Mumsnet users thought of Echo by Lloyd’s Pharmacy. World J Gastroenterol. Obstetric cholestasis, outcome with active management: a series of 70 cases. Gurung V, Middleton P, Milan SJ, Hague W, Thornton JG. Incidentally, the itching started much earlier in this last pregnancy at about 22 weeks. I am 33w pregnant of my 3rd baby now. Of course, if you really are desperate you could tell them you've noticed a reduction in the babies movements - that should get them worried enough to induce you today
It is also known as obstetric cholestasis (OC) and characterized by pruritus with increased serum bile acids and other liver function tests. I'm 38 weeks and the hospital "think" I have OC. It’s not his fault he might have Coronavirus! I am 22wks with baby no.3. (I also had a second baby no oc but went into labour at 24wks, lost baby) the doctors have told me that if I get pregnant again I shouldn't suffer with oc. Cholestasis of pregnancy, also known as obstetric cholestasis or intrahepatic cholestasis of pregnancy, can cause severe itching, especially on the hands and feet. If all tests are normal, but you still itching by 28 weeks, insist on a Bile Acid test. is there no end to the misery of pregancy? I was induced at 37 weeks and feel it was more painful than going into labour naturally: I had to have an epidural and just made do with gas and air for my second birth. Although you get all these reassurances from the doctors, it's somehow comforting to chat to other women who've been through the same. (apart from go to doctor which I will first thing Monday) Should I ask for the liver tests for OC or am I being over dramatic and dangerously self diagnosing? However as the pregnancy progresses it is less able to help, hence the induction. Often the palms of the hands and soles of the feet are the worst affected. Even qualified doctors can't diagnose over the internet, so do bear that in mind when seeking or giving advice. IF they've done a bile acid test (unlikely, it takes 3 days for teh one lab in Birmingham to do this) 10+ indicates OC. was used to compare pregnancy outcomes of this group with those of the general obstetric population (n = 16,818). But it really isn't worth running the risk at this late stage. The rash was much better first thing this morning, but my hands and feet were frantically itchy, and now the rash is starting to spread up my legs and over my bottom again. Obstetric cholestasis is uncommon. Wondering if they will bring forwrad the induction? Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Active management, in the form of close antepartum fetal monitoring and delivery before 37 weeks, helps to decrease the risk of intrauterine deaths, though possibly at the expense of increased obstetric intervention. How did you cope with the itching? Must say it's a better birthday than Hallowe'en. doi: 10.1002/14651858.CD000493.pub2. Following delivery, there is usually a dramatic improvement of symptoms and resolution of the condition. | So during my second pregnancy, and actually what you just spoke on is a great segue, because during my second pregnancy, at 32 weeks, I was diagnosed with cholestasis, and my bile acids were actually really high, kind of scary high. Best of luck - I'm sure you'll be absolutely fine. Yes, it's only the last few weeks OC is a problem but it means early delivery so I really hope it isn't that. Cochrane Database Syst Rev. and this website from the US. It is more common in certain ethnic groups, particularly those from South Asian, South American, Nordic and Scandinavian regions, and has a familial and genetic basis. I found that Rose's Prickly Heat Powder from Hong Kong worked better than anything else. • Pregnant woman in the second half of pregnancy experiencing itch (pruritus) in the absence of a skin rash (other than excoriation) and associated with raised bile acids with or without abnormal liver function tests (raised AST/ALT/GGT) and with no alternative cause and resolving after delivery 3. The most common symptom is continuous itchiness without a rash. I'm 9 weeks pregnant and have been plagued by an awful rash for the past week, which itches like crazy and is driving me mad! Cholestasis risk factors. Prufrock is absolutely right. Hepat Mon. HHS Intrahepatic Cholestasis of Pregnancy (ICP) is a condition in which the normal flow of bile is affected by the increased amounts of pregnancy hormones. Try wrapping your hands and feet in cold towels and plastic bags before you go to bed, and don't overheat the room. Obstetric cholestasis is a multifactorial condition of pregnancy characterised by pruritus in the absence of a skin rash with abnormal liver function tests (LFTs), neither of which has an alternative cause and both of which resolve after birth. It typically presents with itching and can lead to complications for both mother and baby. The hospital doesn't seem very familiar with the condition and the staff seem to assume that because I wanted a homebirth I'm some kind of hippy troublemaker who'll refuse all interventions. Hi Susanita - I had cholestasis with pregnancy number 3 (although I'm sure I also had it with number 1 and it just wasn't diagnosed). TIA. Your liver function tests should be monitored closely and they normally recommend induction at approx 37/38 weeks. I'll see what they say today. The condition triggers intense itching, but without a rash. Thanks as well efmach. Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder in the late second and early third trimester of pregnancy. I also had OC, and the main message I got was that once you knew about it you are OK. Normally, bile acids flow from your liver to your gut to help you digest food. I am being monitored by consultants this time and having blood taken once a month. Walker IA, Nelson-Piercy C, Williamson C. Ann Clin Biochem. Obstetric Cholestasis, sometimes referred to as Intrahepatic Cholestasis of Pregnancy (ICP). He also told me that it was almost certain that I would continue to get OC with subsequent pregnancies with the risk of permanent liver damage to me so my dear hubbie had the snip when I was 35 weeks gone. Mothers whose family birth origins are India or Pakistan have a slightly higher risk (1-2%). Good luck. It is uncommon, affecting 1 in 140 pregnant women (0.7%). Anyway, it wasn't harmful to either me or the baby ("it just happens sometimes during pregnancy" so my gp wasn't very helpful in making the itching stop. It is hypothesised that the surge in pregnancy steroid hormones may result in genetically predisposed women developing cholestasis. The evidence is still not clear and further research is being done. The main symptom is itching of the skin but there is no skin rash. It was diagnosed at 35 weeks the first time and after a lot of faffing about and 'sacking' my consultant my little girl was induced at 38 weeks and she is absolutely fine! I'm going back this morning for monitoring. www - I am really pleased for you. Ive been given guidelines as to what I should do the moment the itching starts. The risk appears to have gone down in recent years but it isn't known if this is because of better pregnancy care or as a result of obstetricians … TBH, if they are doing daily fetal monitoring they will pick up any possible problems. | Medication and lots of checks on my bile acids, medication shouldn't really be taken for a long period of time, I would advise you to talk to your consultant about being induced around 34wks as this will help your baby and yourself. Let's hope it's neither and just allergy/normal itching. Leszczyńska-Gorzelak B, Oleszczuk J, Marciniak B, Poreba R, Oszukowski P, Wielgoś M, Czajkowski K; Zespoł Ekspertów Polskiego Towarzystwa Ginekologicznego. Obstetric cholestasis may increase your chance of having a stillbirth. In ICP, the bile acids do not flow properly and build up in your body instead. 1 This condition is likely multifactorial in etiology. 2002 Mar;39(Pt 2):105-13. doi: 10.1258/0004563021901856. Call the OC helpline on 0121 353 0699 to get more advice - they are really lovely. AIBU to not want in-laws on our ‘holiday’? Has anyone here been diagnosed with Obstetric Cholestasis either in this pregnancy or a previous one? The itching can increase in severity as the pregnancy progresses, and this can interfere with sleep, concentration and mood. At the least they need to be monitoring you in the meantime. I've posted on several threads over the past week, and I'm getting desperate. Frequency of intrahepatic cholestasis of pregnancy (ICP) In Europe, obstetric cholestasis occurs in about 0.1 to 1.5 per cent of pregnancies. For the itching - Ursodeoxycholic acid pills can help - your doc should be prescribing these anyway. susanita Mon 31-Mar-03 15:36:51. All this is why I'd planned a home birth, but obviously induction is looking increasingly attractive now. USA.gov. Hi susanita, I had OC in my 3rd and 4th pregnancy. Role of bile acid measurement in pregnancy. I’m not sure what the chances are getting it again. The condition is also associated with increased perinatal morbidity and mortality, particularly from preterm labour, fetal distress and intrauterine deaths. Is it safe to take ursodeoxycholic acid for so long and does it continue to work for so long? It's on my face and neck, arms, legs, back and bottom. Recent research suggests that the pathophysiology may … Interventions for treating cholestasis in pregnancy. | Im 32 weeks pregnant with 2nd baby. Review of a challenging clinical issue: Intrahepatic cholestasis of pregnancy. I guess Im still mad that I just knew something was wrong, kept seeing doctors and then being told that results were overlooked and I had to be induced immediately to save my babys life. Thanks so much for the info, I'll run back up to the hospital now and hope he's not around and I get sensible people instead. The answer is yes and a woman remains at a high risk that obstetric cholestasis may take place in her future pregnancy. I hadnt started itching until about 37 weeks and, despite going to the hospital 2-3 times after talking with midwives, the doctors at the hospital felt that I couldnt develop OC so late. All experts recommend inducing at 37 weeks if you really do have OC - don't let this crappy consultant fob you off. Obstetric Cholestasis in second pregnancy . 2009 Feb 28;15(8):897-906. doi: 10.3748/wjg.15.897. You might have other, less co… Good luck with the monitoring. Cholestasis usually occurs during the third trimester, but it can occur in the second trimester of pregnancy as well. Obstetric cholestasis (OC) is a pregnancy-specific liver condition that typically presents with generalised pruritus in the absence of a rash in the late second trimester or third trimester. I was in a state of shock, I never expected to be so lucky. The OC Support and Info line is 0121 353 0699. Consultant didn't offer pills, just recommended calamine lotion. I was induced at 37 weeks and had another beautiful girl who does have a condition called craniosynostosis but that was totally unrelated to the OC. 2015 Jun 21;21(23):7134-41. doi: 10.3748/wjg.v21.i23.7134. They told me it would disappear within minutes of giving birth - which it did! I know that the same oversight cannot happen again but Im feeling really very anxious now. Intrahepatic cholestasis of pregnancy is a pregnancy‐specific liver disorder characterized by maternal pruritus in combination with elevated serum total bile acid levels, abnormal liver function, or both. Accurate diagnosis relies on a high index of suspicion, and the findings of abnormal liver function tests and raised serum bile acid levels after the exclusion of other organic causes of liver disease. Most authorities accept elevations of any of a wide range of LFTs beyond pregnancy specific normal ranges. Im also not looking forward to being induced again although I guess that not having some of the surprise/shock of the first time around will hopefully mean I wont be so stressed. Good luck..smileyjo xxx. I came home but the itching has woken me up tonight and is unbearable, especially on my hands and feet. I’m 32 weeks pregnant with 2nd baby. Hi,
It is characterized by pruritis, elevated serum bile acids, and abnormal liver function tests and has been lin … I unfortunately suffered this condition with all my pregnancies and it's truly awful. I'm having daily monitoring and their latest offer is an induction on Tuesday. Thanks! Can it start this early? Mumsnet hasn't checked the qualifications of anyone posting here. This is the complication I am facing since 3 months now and I felt very lonely since this is something very rare apparently. COVID-19 is an emerging, rapidly evolving situation. I had athletes foot a couple of days ago and so I wonder if that's what's causing the foot itching. Many thanks prufrock for all the info. [Clinical practice guidelines of the Team of Experts of the Polish Gynecological Society: management of the intrahepatic cholestasis of pregnancy]. Even with the last pregnancy the itching kicked in at week 35. The pathophysiology of ICP is still not completely understood. eCollection 2016 Aug. World J Gastroenterol. Intrahepatic cholestasis of pregnancy (ICP) is characterised by maternal pruritus and elevated serum bile acids. definitely go to your gp and get checked out. I've just used some spray on that so maybe it'll ease (it's working already, my feet are feeling better) but my hands and arms are still itching and the rash is also still there. On the positive side, if creams/sprays are making the itching feel better it is unlikely to be OC - nothing stops that itching! They did tests yesterday and from reading my notes the levels certainly seem high. My girls are 22 months and 4 months old so it all happened fairly recently. If it turns out you don't have OC and just need to get rid of the itching let me know and I'll send you what I've got left. The major clinical features, diagnosis, and management of ICP will be reviewed here. You poor thing Dannie. Intrahepatic cholestasis of pregnancy. It is associated with adverse perinatal outcomes including stillbirth, preterm labour and neonatal unit admission. Get the Liver Function Tests, get your urine checked for Bilirubin (also an indicator, especially at this early stage). acids in your body. Good luck. Her great informed suggestion was Calamine lotion (as if I hadn't tried that already in the 2 weeks before I got to see her). Hope you feel better soon. Sorry to ramble on, Im just a little scared now Ive reached the final stages. Apparently this brings down the level of bile acids in the blood. susanita
And so I was on ursodiol through that pregnancy, and in conversations with my doctor, we decided that it was best that I would need to be induced at 37 weeks … It's run by a lovely midwife, based in Birmingham I think. I’ve been battling a rash and severe itching for the past several weeks and three different doctors believe it may be this, but it didn’t show up in my liver function on the last round of my bloodwork. My consultant was happy to monitor every 2 days at the end - if everything was OK and the baby was moving about lots they were happy I was safe. It affects around 0.7% of pregnancies in the UK 1 and typically presents in the third trimester. Have they done LFT's and bile acid tests? The figures they will look at in your notes are the transemanine levels from a LFT (over 45 is an indication of a possible diagnosis - mine got over 200 at one point!). Do you have questions about creating positive bathroom habits and routines? Intrahepatic cholestasis of pregnancy (ICP) is a potentially serious liver disorder that can develop in pregnancy. It is also known as obstetric cholestasis (OC) and characterized by pruritus with increased serum bile acids and other liver function tests. Has anyone else had obstetric cholestasis in a second pregnancy after having it in first? www. Ursodeoxycholic Acid and S-adenosylmethionine for the Treatment of Intrahepatic Cholestasis of Pregnancy: A Meta-analysis. like sofia, was told it was "just normal pregnancy itching". Hi Dannie, how are you and what happened at the hospital yesterday? I had oc at 22 wks with my first baby (Stillborn) due to other complications so please try not to be alarmed. Intrahepatic cholestasis of pregnancy (ICP) is a poorly understood disease of the late second or third trimester of pregnancy, typically associated with rapid resolution following delivery. The pathophysiology of ICP is still not completely understood. 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