The itching explained - Obstetric Cholestasis!

[Now we're 3]

Hi ladies

Hope you can help

After mentioning the overall itching that I had just started experiencing to my OB last week he immediately sent me for blood test which came back unfortunately on Friday to confirm that I had increased levels of bile salt in blood steam. He has put me on an anti-biotic which he had told me about at the visit. Wanted to start immediately this immediately so had faxed the script to my local pharmacy - who were more than happy to fill the script and take my $200 !!!!!!!

He has moved my weekly Tuesday appointment to Monday and wants to discuss then if my pregnancy is causing this conditioin whether I need to remain pregnant! I will be 38 weeks on Monday. Baby is IVF baby so we do know that the dates are 100% correct and that at 38 weeks baby would be fine.

I am reluctant to google the condition too much as I know how scarey some of the information you read on line can be - especially when information source is unknown - but would like to have some information prior to seeing OB on Monday and having discussion.

What if anything do you ladies know about the condition and what are your thoughts regarding having the baby "early".


Any insights/ experience would be really appreciated.

Thanks

[Shades]

As I understand it 38 weeks (especially with the certainty of IVF dates) is not considered 'early' so it then becomes a question for you about what sort of birth experience you were after - if you're not fussed about induction vs going into spontaneous labor etc then I don't see an issue... in the same situation I'd probably try to compromise by giving it one more week (to 39 weeks) and then go ahead with induction if nothing has begun on it's own... it depends how long you can put up with the itching I guess...

[amy_o]

I had OC as well and delivered at 35weeks when my liver functions dropped way too low and became a real risk to DD. I know that inductions are rough (ohhh boy do I know that one!!) but OC is NOT to be messed with. If you have been reading on the net you know that after 37weeks in the danger zone for mum and bub. The risk of having the baby early is far less than the risk of letting the pregnancy contiue. I know it sounds harsh but I have been there and I know how close we can to losing our little one. If you are at 38 weeks bubs is fine and dandy to join us here in the world so my attitude would be better safe than sorry. Just my experiances though. In the end all you can do is talk with your OB and make the decision that is right for you.
All the very best
I will be thinking of you and bubs!!

[LionsandBears]

I don't want to freak you out, but I did recently read a blog of a lady who lost her bub, due to OC, at 35 weeks. Bub stopped moving the day they got the test results back.

I would seriously go with the OB's suggestion. You are now term, so bub should be safe to come out.

GL

[Now we're 3]

Thanks ladies - will let you know how I go. Pretty certain he will suggest I go early just a matter of what day this week rather than if it is this week.

Yikes - all happening so quickly now.

Guess the decision then is induction or c/s section. Had read that labour after induction can be rough and OB also thinks baby is on the larger size for my build but recovery after section isn't the easiest of roads either. Will just have to listen to what the experts say and go with what is safest for both of us - or more particularly the baby.

Thanks for your advice and thoughts X

[Trillian]

Personally if it were me I would still go for an induction rather than a c/s because 1 you may be able to vaginally birth your baby perfectly fine (and yes, I only know too well how rough an induction can be!) and bubs may not be too large at all and 2 if there is no medical reason why the OC would prevent a vaginal birth then go for the induction as even if it does end in a c/s your baby has had the benefit of some labour. There is a member here Bathsheba who had an induction at 37wks for OC I hope she see this and pops in to share her story.

[Now we're 3]

Thanks - quick question - is it the actual induction itself that is the painful bit or that the labour pains can be more intense if you are induced as opposed to going naturally? I haven't read too much about it as had no need before now. And this weekend was more focused on finding out some information regarding OC rather than what way I would give birth! Am always cautious about googling too much as you are inclined to hear more of the "bad" stuff and can scare yourself to death.

[Bathsheba]

Yep, here I am LOL.

Like Trill said I had OC and had an induction at 37weeks. I never considered a c-section as it poses more risks to both me and baby. The induction was tougher than a natural birth but like Amy said OC can be very risky beyond 35 weeks. I was very worried that my bub wouldn't be ready to come into the world as my previous 2 babies were born at nearly 42 weeks! But he was fine and was a very healthy 9 pounds. Anecdotally there seems to be a link with OC and big babies he was also born with his arm up around his head... but I was totally fine, no tears, and it was fantastic to be able to get up and walk around and care for him hours after the birth with no further pain.

My itching was almost unbearable... especially around my ankles... but this stopped as soon as I gave birth... amazing.

Also I don't understand why the doctor prescribed antibiotics for OC???? That seems strange. I wasn't put on any form of medication except Polaramine (anti-histamine) to help the itching but that was only $13 a packet.

I hope everything goes well for you. If you end up having an induction don't let them rush you!!! Syncotin can be often over done... causing unnecessary pain during labour and a risk to the babies breathing if all the contractions run into each other. If you have considered hiring a doula (like I did) I would highly recommend this. And ask if you can started off gently in the induction process... if they start by applying a gel to your cervix that might be all it takes for you body to go into natural labour. Failing that... they then could try breaking your waters... for me that really got things going... I only needed a very small amount of syncotin to help me get baby out within the doctors time frame.

Goodluck!

[Trillian]

It's not the induction, it's the contractions. When you are induced your body is sent into an artificial labour you could call it. The induction drugs are forcing your uterus to contract at a pace much faster and harder than they would normally occur - a way to imagine it is if you get a ball and put it in your hand and repeatedly squeeze it hard on and off every 3 minutes - your hand gets tired really quick and that's what is the hardest. Your body can get really tired really quickly. Normally I wouldn't advocate for an induction at all, but this is one of those times where bubs is better out than left in and I would always rather that a women attempt a vaginal birth first. There are some excellent articles on the bb main site www.bellybelly.com.au/articles that I recommend you read. It's really nothing to be worried about as women do have inductions all the time, but it really does pay to educate yourself about what you can expect.

[Bathsheba]

We posted at the same time Meadsie so i missed you last question about the pain... Trillian explained it well. I also edited my last post and added some extra info.

[Now we're 3]

Thanks ladies really really appreciate your input. Heading off now to see OB so will let you know how we go and what the verdict is.

Sorry Bathsheba - may have used the wrong word when i said antibiotic as i've been given a drug - Ursodeoxycholic acid - which is used to restore the liver function and bile acids to their normal standard. Therefore can assist in eliminating the itching and make life more bearable.

Be back on later with more news - thanks again.

[Trillian]

Well good luck today and I hope all goes well with your birth if you don't get a chance to log on again

[Bathsheba]

Ah ok... about that drug you are taking: I think my GP might have mentioned it... but my levels never got too high to warrant it... and at $200 I'm glad! The money was very much worth going towrad a doula instead! I hope your OB takes things gently and slowly for you! Remember that you still have a say in how your baby is born. The BB articles Trillian linked to are an excellent source of info... they don't scare you unecessarily!

[Now we're 3]

Well all official now - motherhood here we come - bit earlier than planned but all good.

Booked in for tomorrow so in a little over 24 hours I'll be a mum. After discussion between us and the OB and full examination seeing way baby is positioned, the way my cervix is/isn't have decided to go down the c/section route rather than attempting the induction. Mightn't be everyones choice but believe it to be best for us.

Thanks for all your input and look forward to speaking to you from the other side!

Any bets on how much sleep i end up getting tonight ?????

[Shar]

WOW, Good luck and let us know your news!

[Doing my best]

Any bets on how much sleep i end up getting tonight ?????

NOt much !! Both mine were ceasers and I got about 2 hrs the night before DD was born, and not much more before DS was born (with him I was having contractions though).

Good luck for your birth.. And as long as you are comfortable, then it is the right decision..

[Jewel]

Good luck with tomorrow. You'll be holding your bubba in your arms in no time.
Super exciting!!! I hope you get some rest tonight.

xox

[chickenlittle]

Oh wow... so soon! How exciting! Good luck!