Obstetric Cholestasis

[Lolly]

We are going to be TTC in June of this year for number 2. I developed Obstetric Cholestasis with my first pregnancy and I am quite nervous about the prospect of another pregnancy with this condition. I know the chances are high that I will get it again and have resigned myself to this fact. I was wondering if there are any other expectant mum or mums who are TTC who have had this condition with a previous pregnancy?

Lolly

[pollyanna]

Hey there Lolly,
Unfortunately i FIT your criteria. I had cholestasis of pregnancy with both children. I am now on ths very long path of AI to get to this next pregnancy. i am more than aware that it will result in the probable following scenarios,gestational diabetes,cholestasis of pregnancy and hypertension all of which result in early induction. Obviously i'm not thrilled about any of that,but i want this baby more than anything. I do believe though that there is now medication for cholestasis that is meant to ease the livers inflammatory response and therefore make a slight difference to the symptoms.I'm hoping that that is the case.

[Lolly]

So glad you replied Pollyanna. I have so many questions, you are the first real person I have spoken to that has had it. I have looked at a heap of websites but it isn?t the same as actually relating to a person IYKWIM. Everyone I mention this to has no idea what I am talking about. When you mention that it can make you itchy they say oh it?s just an itch that isn?t so bad. How little do they know.

Was it worse with your second compared to your first? Did you do anything during your second pregnancy to try and reduce the risk of it happening again or the severity of the symptoms? Did you have a family history? I am the first in my family so that is why I had no idea about any of it until after my son was born.

I ended up with emergency CS with Harry so I have resigned to the fact that the next one will be an elective CS as I have been advised my the gyno at my 6 week check up after he was born that they will not do an induction after you have a CS. Only way I will get a virginal birth is if I go early before the 36 week mark on my own which isn?t really the best option for the baby.

Did you go public or private? I went public with my first and found the care I received was great after I was diagnosed but before I was diagnosed not so good. In there defence I had only moved into the area and booked into the hospital a few weeks before but it has still left me a little anxious. How many weeks where you when you delivered your baby?s?

I am sorry but I am a little vague on the acronyms what does AI mean? When are you planning for your next? It would be great to have someone who is going through the same thing as me to chat to.

Sorry about all the questions but again, I am so happy you replied.

Lolly

[Bathsheba]

I had Cholestasis with my 3rd pregnancy. It is one of the reasons i won't be having another child but that's just my choice, don't let me put you off I sympathsise with the itching! OMG it kept me awake at night toward the end... it was so bad on my feet and palms that it was like I had chickpox but without any rash so people just don't understand what you are going through (I had chicken pox as an adult). I was induced at 37 weeks in a public hospital. It went as well as could be expected although I felt a bit rushed... another topic!

Unfortunantly I have developed an ongoing health condition (hyperthyroidism, I have another thread about it) that my endocrinologist thinks could be related to the cholestasis (my thyroid is enflamed). Don't fret about this... just maybe keep it in mind.

I hope all goes well. I understand the desire for another child despite the risks... don't worry too much... one day at a time.

[Lolly]

Bathsheba

Thanks for your reply also.

I originally said that I wasn?t going to have another for about the first 12 months after he was born as it was all still to fresh in my mind. But I really feel like he needs a sibling and I would really like to have another. I had the symptoms from about 7 months with him but being a first time mum I just thought it was my body doing the usual crazy pregnancy things. I managed to get to just before 39 weeks before I couldn?t take it anymore and went and found a new GP who new what it was strait away.

My son was born about 24 hours after seeing him. I did contact the midwifes at the local hospital a few times before that but she told me that I was reading to many books (literally) she made me feel really stupid and that I was over reacting. When I think about it now, I was stupid. Stupid for not listening to my intuition.

At least this time around I will know what is going on and what signs to look for so hopefully it would not go as long being undiagnosed. I blame myself for that because when I think back now I knew something was defiantly wrong by the 8 month mark but didn?t want to be seen as a complainer. I was such an idiot and I kick myself knowing the risk that I put my son in. I defiantly will not allow them to dismiss me this time round now that I know what I am dealing with.

[pollyanna]

Hi Lolly,
Happy to reply,
Ok as for when am i planning on pregnancy well that depends on the AI-assisted conception. IVF. as i havent conceived in over two years of trying.So its a wait and see game every month.
As for the cholestasis yes most of my family has now been tested and have been diagnosed with a liver condition called gilberts syndrome. It dosent affect all of them just some. Not my mother,father or sister. Mine is essentially only pregnancy cholestasis so all symptoms go away immediately after birth. There is nothing that can be done from a preconception level to prevent it. The second pregnancy was not any worse that the first as far as itching. Both times it was diagnosed at 7 months in a public teaching hospital. Back then there was not any treatment available 1997 and 1999. They just gave me calamine lotion. Which di nothing except make me look like MOBY the giant white whale. I remeber lying in bed at night crying because i was itching so badly.Oddly enough it was really only a major problem for me when i wanted to get to sleep.
I had natural deliveries with both children. One i was very drugged out and took over 12 hours the other no drugs and over in 3 hours. It is so nice to share the journey with someone who personally understands,just what an awful condition it is-but even still not enough to stop me. Hope i have helped. I'm happy to chat anytime.

[Bathsheba]

Don't let them make you feel silly darl. I self-diagnosed my Cholestasis. I was up late one night and Googled "pregnancy itch hands feet". After reading the symptoms I knew I had it. I went to the doctor the next day and told him that I had it and requested a blood test to confirm it. He just said, yep, you've got it after reading the result. If you are wrong about a self diagnosis then great! it's nothing to be ashamed of either way.

I find that most health professionals are too rushed these days to be really thorough (just my personal experience) and that most people (patients) would do well to be more proactive. People need to take more responsibility for their own health and not just blindly follow their doctors... be sensitive to the way your body is working, know how it should work and don't ignore little symptoms if they don't go away. Ok rant over LOL

Your reasons are perfectly sound... you don't need to explain yourself. Maybe seek the advice of a natropath who can give you a more holistic (complete/overall) health assessment and maybe suggest ways you could gently make the likely hood of a repeat episode smaller. My natropath has been invaluable during my current bout of illness. He actually looks at me and my body as a WHOLE (whereas a traditional GP will just seek to cure illness.... once again, generally speaking).

[Mollygirl]

I had a mild case of this and thought the itching was just normal. It was funny because I ended up at the hospital on a Wednesday afternoon because I had pains on my right side, under my ribs, I appeared to be in quite a bit of pain over the phone so they said come in and we will check you out. I thought the itching was nothing much and it was DH who mentioned to the midwife who told my OB so I went back the next morning for the blood test. I was 37w and 3 days. The CTG was fine and I went home.

When I went to the OB after the blood test the next day, he said something like we do check these things out. The thing is that I didn't know how serious it was, or even to mention it to him in the first place. Funnily the itching only started after I had been hot and walking around the city on the Friday before, but by the Tuesday I was scratching my arms enough for a friend and her colleague to notice and she said to tell my doctor at my next appointment.

Well, my waters broke on the Friday morning and because I didn't have any contractions for 6 hours but was 2cm dilated I was put on the drip and had her 1hr 45 mins later. I also couldn't feel her moving and my ob described her as 'sleepy'.

When I went back for my 6 week check up I asked my doctor about the blood test results and that was when I found out my liver hadn't been functioning properly, but was only a mild case. The doctor wasn't going to say anything until I asked!!! I did ask him if he would have induced me if I hadn't gone naturally and he said yes.

So, when my colleagues at work told me they were pregnant I told them to tell their doctor if they get itchy because I feel like we worry that we are 'self diagnosing' and I was worried my doctor would laugh, that is why I didn't go to the doctor on the Monday after the itching started, when I really should have. (I did the search on the net on the Saturday and realised I could have it, but still didn't do anything).

We really do need to feel more empowered about the care we receive.

[sconeonamission]

I can't help with any information, but my cousin had this with her baby and ended up needing to be induced about 4wks early. Mother and baby were fine.

HTH Good luck!

[Lolly]

Thanks everyone for your advise and responses. We are going to TTC in June this year. Not sure if I am ready for the roller coaster ride of pregnancy again but not sure I ever will be so I am just going to get it over with. Never now I may be one of the minority and not get it again. Fingers crossed.

Thanks again

[Bathsheba]

My natropath suggested I try a liver cleansing diet/program before falling pregnant again but I told him my family was complete. Maybe speak to a natropath and see what they have to say.... they often offer free advice if they run their own health food store.

[ScottishMummy]

Is ursodyoxicolic acid used in OZ as a teatment for OC? I developed cholestasis in my first pregnancy (in the UK) and these tablets rapidly reduced both my bile acid levels and the itching!

Now pregnant with number two and moving to Sydney...doesn't seem like any of you ladies have been treated with this?

Helen x

[madmotherwhoscraps]

Yeah....I have just had baby number three and had this awful condition for the first time! My doctor told me that there is a 1 in 3 chance of getting it again if I decide to have a fourth child. Even though the end result was a perfect baby girl.....getting to term and remaining sane are difficult!
Good luck

[fussyB00ts]

Lolly,
just wanted to add my two cents worth. I'm having my first child in October so haven't had Ob Cholestasis...yet. But my sister had it with her first child, but not with her second. So it is possible that you won't get it a second time, so fingers crossed.

By the way, I agree with Bathsheba, don't just rely on your GP or Ob for treatment...find a good naturapath, or maybe a kinesiologist. Hopefully they'll be able to help support your body through it better, or perhaps even help prevent it in the first place.

Good luck