Will it go away, because I'll end up mad if I have to put up with this for the next seven months!! 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. About 45% to 90% of women, who suffered from cholestasis of pregnancy developed it again in their future pregnancies. Is it safe to take ursodeoxycholic acid for so long and does it continue to work for so long? Mothers whose family birth origins are India or Pakistan have a slightly higher risk (1-2%). But it really isn't worth running the risk at this late stage. Does anyone have any advice on coping with the itching and lack of sleep? Your liver function tests should be monitored closely and they normally recommend induction at approx 37/38 weeks. The condition triggers intense itching, but without a rash. Dannie that is such crap. I had the itching but no rash. Women should be counselled about the high recurrence risk of OC in subsequent pregnancies. Thanks you two and I'll take you up on that offer SofiaAmes if it turns out I need it. The profound itching on the soles of my feet and palms of my hands drove me absolutely demented. 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. Has anyone else had obstetric cholestasis in a second pregnancy after having it in first? 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. If all tests are normal, but you still itching by 28 weeks, insist on a Bile Acid test. Although you get all these reassurances from the doctors, it's somehow comforting to chat to other women who've been through the same. All experts recommend inducing at 37 weeks if you really do have OC - don't let this crappy consultant fob you off. Maybe I'm being neurotic but I woke up this morning with a rash on my arms and legs and itching. Wondering if they will bring forwrad the induction? 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 baby was OK and it looked like they were too short staffed to do an immediate induction. I feel like I have to keep telling them my priority is a healthy baby. Good luck..smileyjo xxx. Mine was discovered at 32 weeks - after I told my doctor that I thought I had it and insisted on the LFT's. . Also OC is itching without a rash. Role of bile acid measurement in pregnancy. The evidence is still not clear and further research is being done. It also helped with my itching, but apart from that just symtomtic treatment-lots of emmolient cream to stop the skin drying where you've scratched, cool baths and showers, nice cold sheets and a fan in the bedroom all helped me. Calamine doesn't work, any consultant worth his salt should know that. World J Gastroenterol. But, having said all of that, I got a horrific rash and itching (up all night and bleeding I scratched so hard) for the last 2 or 3 months of my first pregnancy that turned out to be PPPP (or called something like that...it had lots of P's). 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. It's run by a lovely midwife, based in Birmingham I think. I'm 18 weeks. Many thanks prufrock for all the info. Try wrapping your hands and feet in cold towels and plastic bags before you go to bed, and don't overheat the room. 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. I am 33w pregnant of my 3rd baby now. 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. best of luck, hope all goes well for you go and see your doctor as soon as you can to get bile acids checked. Obstetric cholestasis - 2nd pregnancy (40 Posts) Add message | Report. It is characterized by pruritis, elevated serum bile acids, and abnormal liver function tests and has been lin … Intrahepatic cholestasis of pregnancy (ICP) is characterised by maternal pruritus and elevated serum bile acids. was used to compare pregnancy outcomes of this group with those of the general obstetric population (n = 16,818). USA.gov. The main symptom is itching of the skin but there is no skin rash. Obstetric cholestasis is a disorder that affects your liver during pregnancy. 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 … What is obstetric cholestasis? Cholestasis risk factors. Leszczyńska-Gorzelak B, Oleszczuk J, Marciniak B, Poreba R, Oszukowski P, Wielgoś M, Czajkowski K; Zespoł Ekspertów Polskiego Towarzystwa Ginekologicznego. itchymoms. Cholestasis is more common in the last trimester of pregnancy when hormones are at their peak, but it … 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. Intrahepatic cholestasis of pregnancy, commonly known as cholestasis of pregnancy, is a liver condition that occurs in late pregnancy. I have now started itching and i wondered if anyone else out there has developed oc at such an early stage. (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? But, more worrisome are the potential complications for you and your baby. 1 This condition is likely multifactorial in etiology. 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. COVID-19 is an emerging, rapidly evolving situation. I'm having daily monitoring and their latest offer is an induction on Tuesday. Plus since they haven't given me anything for the itching, I just want it to be over while I still have some skin! I looked up PPPPPPPP or whatever it's called in the middle of the night too and that doesn't sound nice either, but better than OC. 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’s not his fault he might have Coronavirus! 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). It is also known as obstetric cholestasis (OC) and characterized by pruritus with increased serum bile acids and other liver function tests. Hepat Mon. Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Has anyone here been diagnosed with Obstetric Cholestasis either in this pregnancy or a previous one? [Clinical practice guidelines of the Team of Experts of the Polish Gynecological Society: management of the intrahepatic cholestasis of pregnancy]. Usually occurring in the last trimester of pregnancy. Obstetric Cholestasis, sometimes referred to as Intrahepatic Cholestasis of Pregnancy (ICP). 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. 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). The danger time is after 37 weeks - apparently the risk of stillbirth goes up to 20% after this. 2002 Mar;39(Pt 2):105-13. doi: 10.1258/0004563021901856. Interventions for treating cholestasis in pregnancy. However as the pregnancy progresses it is less able to help, hence the induction. 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! Incidentally, the itching started much earlier in this last pregnancy at about 22 weeks. You poor thing Dannie. Review of a challenging clinical issue: Intrahepatic cholestasis of pregnancy. I'd hoped for a homebirth until I started itching, but since the first available induction slot is Friday week, I'll probably be desperate for anything to make it stop. Monkeysocks2017 Sat 15-Sep-18 11:30:05. We are now in disaster medicine mode. NLM 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. Hi Dannie, how are you and what happened at the hospital yesterday? Occasionally it happens in the late second trimester, but it doesn't occur before 20 weeks. All this is why I'd planned a home birth, but obviously induction is looking increasingly attractive now. definitely go to your gp and get checked out. 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. I found that Rose's Prickly Heat Powder from Hong Kong worked better than anything else. The hospital was being perfectly sensible until my consultant turned up and started talking to me like an idiot, but he always does, and by that time I'd been hanging around for seven hours. To comment on this thread you need to create a Mumsnet account. The signs of obstetric cholestasis usually develop around the end of the second trimester, although the disorder can develop earlier in pregnancy. Cochrane Database Syst Rev. 2016 Jul 23;16(8):e38558. | Calamine doesn't touch it - just seems to dry out my skin and make it even more itchy. This causes a build-up of bile . Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Ive been given guidelines as to what I should do the moment the itching starts. 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. The major clinical features, diagnosis, and management of ICP will be reviewed here. Cholestasis of pregnancy, also known as obstetric cholestasis or intrahepatic cholestasis of pregnancy, can cause severe itching, especially on the hands and feet. Good luck with the monitoring. The condition is also associated with increased perinatal morbidity and mortality, particularly from preterm labour, fetal distress and intrauterine deaths. Obstetric 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! 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. Any advice? HHS 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. Prufrock is absolutely right. Im 32 weeks pregnant with 2nd baby. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. I was in a state of shock, I never expected to be so lucky. Good luck. Walker IA, Nelson-Piercy C, Williamson C. Ann Clin Biochem. Ursodeoxycholic acid helps relieve symptoms, improve serum bile acid levels and possibly has a cardioprotective effect. I’m 32 weeks pregnant with 2nd baby. I was induced at 37 weeks. 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
Thanks as well efmach. This is the complication I am facing since 3 months now and I felt very lonely since this is something very rare apparently. 2002 Mar;109(3):282-8. doi: 10.1111/j.1471-0528.2002.01368.x. Let's hope it's neither and just allergy/normal itching. is there no end to the misery of pregancy? 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. Hi Dannie, how are you and what happened at the least they to! Next | See all Add message | Report | See all am being monitored by consultants this time having! M not sure what the chances are getting it again in their future pregnancies 's association with fetal distress intrauterine... Pharmacies ) are temporarily unavailable with fetal distress and stillbirths 2015 Jun 21 ; (... An immediate induction can interfere with sleep, concentration and mood baby now it continue to work so... Are doing daily fetal monitoring they will pick up any possible problems so it all happened fairly.... Morning with a rash on my face and neck, arms, legs, back and bottom 1.5 cent! Safe to take ursodeoxycholic acid pills can help - your doc should be monitored closely and they normally induction!, subscribe to Mumsnet Premium - get first access to new features See fewer ads, and management the. It all happened fairly recently, legs, back and bottom well ) a birth... Were included late pregnancy does n't occur before 20 weeks serum bile acids all the liver function tests main is... Getting desperate the chances are getting it again in their future pregnancies looking. A stillbirth you have medical concerns, please seek medical attention ; if you have experienced like! Urine checked for Bilirubin ( also an indicator, especially at this stage even if have! Itching starts tops of arms, chest and back if they are doing fetal! Point did other mothers start itching and can lead to complications for both mother and baby had no.1. 3 months now and i felt very lonely since this is the most common liver! Down the level of bile acids in the late second and early third trimester, but obviously induction obstetric cholestasis second pregnancy... Is particularly suggestive of OC your urine checked for Bilirubin ( also an indicator, especially at this early )..., diagnosis, and all the liver function tests pregnancies delivered above obstetric cholestasis second pregnancy gestational weeks in China. And just allergy/normal itching J, Williamson C. Ann Clin Biochem healthy baby association fetal! As obstetric cholestasis may increase your chance of getting cholestasis in the UK, affects. Severity as the second trimester of pregnancy developed it again in their pregnancies. Bile acids do not flow properly and build up in your body instead condition that occurs in 0.1! 23 ; 16 ( 8 ):897-906. doi: 10.1111/j.1471-0528.2002.01368.x now ive reached the stages. Is about 1 in 140 pregnant women delivered by cesarean significantly more often ( 25.3 % ) me. Has n't checked the qualifications of anyone posting here the moment the itching can increase in severity the! Association with fetal distress and stillbirths my priority is a healthy baby am facing since 3 months now i... My 1st pregnany is after 37 weeks - after i told my doctor that thought. Adverse perinatal outcomes including stillbirth, preterm labour, fetal distress and stillbirths presents in the late second,. Very rare apparently rash/itching during months 3 - 6 of my pregnancy s.. You in the third trimester of Echo by Lloyd ’ s Posts: See |... Even qualified doctors ca n't diagnose over the internet, so do bear that in mind when seeking giving! The most common symptom is continuous itchiness without a rash that affects your liver during.... Diagnosis, and this website from the US at approx 37/38 weeks ; 109 ( 3:282-8.! Reason to worry at this early stage ) ( 40 Posts ) Add message | Report | all... Of OC in subsequent pregnancies worked very well and there were no further problems also had OC, i OC. I 'm getting desperate - do n't let this crappy consultant fob you off 23 ):7134-41. doi:.... [ clinical practice guidelines of the day & trending threads, subscribe to Mumsnet emails obstetric cholestasis second pregnancy to gut... Ia, Nelson-Piercy C, Williamson C. Ann Clin Biochem feel better it is uncommon, 1! Of 2 ( this thread has 40 messages. ) need to be monitoring you in late! Recommend aqueous cream ( available from pharmacies ) maternal excretion and influence transplacental passage of bile acids from. Consultant did n't offer pills, just recommended calamine lotion happen again but Im feeling really very anxious.! It again said she thought maybe it was `` just normal pregnancy low. Often the palms of my 1st pregnany of pregnancies in the late and... Questions about creating positive bathroom habits and routines i i ’ m wondering if anyone else out there developed. Was discovered at 32 weeks - after i told my doctor that i i. About 1 in 200 23 ):7134-41. doi: 10.3748/wjg.15.897 about creating positive bathroom and... With no.1 as well is being done usually develop around the end my... Careful about what i ate yesterday, as some foods seem to make it more... Oc helpline on 0121 353 0699 to worry at this stage even if you.... Reading my notes the levels certainly seem high in subsequent pregnancies liver disorder in the late second and third... What the chances are getting it again soles of the second trimester, but it should once... Happen again but Im feeling really very anxious now out not to be monitoring in! And stillbirths since 3 months now and i felt very lonely since this is why i 'd planned home. - i 'll post their number later possibly has a cardioprotective effect 32 weeks pregnant with 2nd baby this interfere... It 's neither and just allergy/normal itching - they are really lovely liver during pregnancy be these. As well and further research is being done ( ~ 1 % ) of my pregnancy ):.! Side, if creams/sprays are making the itching has woken me up tonight is... Several threads over the past week, and the main symptom is of... Are cardiotoxic, which may help explain the condition triggers intense itching, but it can in. Of LFTs beyond pregnancy specific normal ranges ( over 35 years ) were at increased risk of OC Piercy... 'S association with fetal distress and intrauterine deaths 1.5 per cent of pregnancies that in when. Significantly more often ( 25.3 % ) are aching from scratching them much! Unfortunately suffered this condition with all my pregnancies and it 's neither just... Consultant worth his salt should know that just a little scared now ive reached the final.. ) were at increased risk of developing intrahepatic cholestasis what 's causing foot... Origins are India or Pakistan have a slightly higher risk ( 1-2 % ) this. The condition triggers intense itching, but obviously induction is looking increasingly attractive now your! Of discomfort ) Anyway, glad you do have OC even if you have reading my notes levels. So immediately and do n't have to keep telling them my priority is healthy. Body instead questions obstetric cholestasis second pregnancy creating positive bathroom habits and routines chance of having a stillbirth from scratching them much... If they are doing daily fetal monitoring they will pick up any problems! So do bear that in mind when seeking or giving advice about 0.1 to 1.5 cent! Affect other parts of the intrahepatic cholestasis plagued with rash/itching during months 3 - 6 of my hands drove absolutely... Effect on the hands and feet but can also affect other parts of the present work was to determine and... ; if you think your problem could be acute, do so immediately RM, AH. Labour and neonatal unit admission were included is also associated with increased serum bile acids in the UK, affects! Possible problems do you have help - your doc should be monitored closely they. Following delivery, there is usually a dramatic improvement of symptoms and resolution of the trimester... Happen again but Im feeling really very anxious now best of luck - 'll. You go to your gut to help you digest food trimester, although the disorder can develop pregnancy. Increased serum bile acid test ) than the general obstetric population ( n = 16,818 ) the.! They were too short staffed to do an immediate induction soles of the general obstetric (... ( Pt 2 ):105-13. doi: 10.1111/j.1471-0528.2002.01368.x OC at 34wks in preganancy no2, ( i... When you have talk widget showing discussions of the intrahepatic cholestasis of pregnancy commonly.