obstetric cholestasis second pregnancy

I unfortunately suffered this condition with all my pregnancies and it's truly awful. I’m 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 won’t be so stressed. Prufrock is absolutely right. Oh he's a marvel, but I've already moaned about him elsewhere on Mumsnet. Can it start this early? Please enable it to take advantage of the complete set of features! I'm going back this morning for monitoring. Affected pregnant women delivered by cesarean significantly more often (25.3%) than the general obstetric population (15.8%). Obstetric Cholestasis, sometimes referred to as Intrahepatic Cholestasis of Pregnancy (ICP). It is hypothesised that the surge in pregnancy steroid hormones may result in genetically predisposed women developing cholestasis. Cholestasis of pregnancy, also known as obstetric cholestasis or intrahepatic cholestasis of pregnancy, can cause severe itching, especially on the hands and feet. Interventions for treating cholestasis in pregnancy. It is characterized by pruritis, elevated serum bile acids, and abnormal liver function tests and has been lin … The danger time is after 37 weeks - apparently the risk of stillbirth goes up to 20% after this. I was diagnosed with Obstetric Cholestasis right towards the end of my 1st pregnany. Talk widget showing discussions of the day & trending threads, Subscribe to Mumsnet emails direct to your inbox. 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. I believe it can even start as early as the second trimester. My girls are 22 months and 4 months old so it all happened fairly recently. Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder in the late second and early third trimester of pregnancy. definitely go to your gp and get checked out. It's run by a lovely midwife, based in Birmingham I think. Is this OC? 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. The most common symptom is continuous itchiness without a rash. You should definitely get your gp to test you on monday, but you've got quite a bit of time to find out if you've got it before you have to worry that they haven't acted quickly enough. Intrahepatic Cholestasis of Pregnancy (ICP) is a condition in which the normal flow of bile is affected by the increased amounts of pregnancy hormones. Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Gurung V, Middleton P, Milan SJ, Hague W, Thornton JG. All this is why I'd planned a home birth, but obviously induction is looking increasingly attractive now. NLM susanita ICP typically presents after 28 weeks of gestation with pruritus most commonly of the palms of the hands and soles of the feet, and sometimes intractable. Good luck..smileyjo xxx. Calamine doesn't work, any consultant worth his salt should know that. I was diagnosed with Obstetric Cholestasis right towards the end of my 1st pregnany. 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. take care. Does anyone have any advice on coping with the itching and lack of sleep? Even qualified doctors can't diagnose over the internet, so do bear that in mind when seeking or giving advice. The answer is yes and a woman remains at a high risk that obstetric cholestasis may take place in her future pregnancy. Take a look at the itchymoms site if you like but there are some very sad stories on there and to be honest they scared me quite a bit! The major clinical features, diagnosis, and management of ICP will be reviewed here. Obstetric cholestasis is a multifactorial condition of pregnancy characterised by pruritus in the absence of skin rash with abnormal liver function tests (LFTs) neither of which has an alternative cause and both of which resolve after birth. I saw the doctor this week, who thought it was a reaction to pregnancy hormones (it's my 2nd pregnancy, but I had nothing like this in the last one). I was diagnosed with OC at 34wks in preganancy no2, (although i had with no.1 as well). Mine was discovered at 32 weeks - after I told my doctor that I thought I had it and insisted on the LFT's. • 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. Plus since they haven't given me anything for the itching, I just want it to be over while I still have some skin! 2015 Jun 21;21(23):7134-41. doi: 10.3748/wjg.v21.i23.7134. 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/. www - I am really pleased for you. 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. 2009 Feb 28;15(8):897-906. doi: 10.3748/wjg.15.897. To use this feature subscribe to Mumsnet Premium - get first access to new features see fewer ads, and support Mumsnet. Frequency of intrahepatic cholestasis of pregnancy (ICP) In Europe, obstetric cholestasis occurs in about 0.1 to 1.5 per cent of pregnancies. I guess I’m 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 baby’s life. www, I'm sure you'll have more accurate responses from the medical experts and midwives, but my understanding is that OC is important to spot, but is actually only dangerous to the baby during the last few weeks of the pregnancy. I had athletes foot a couple of days ago and so I wonder if that's what's causing the foot itching. Call the OC helpline on 0121 353 0699 to get more advice - they are really lovely. It is also known as obstetric cholestasis (OC) and characterized by pruritus with increased serum bile acids and other liver function tests. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. Your liver function tests should be monitored closely and they normally recommend induction at approx 37/38 weeks. My palms are very red and my hands are aching from scratching them so much. Obstetric cholestasis, also known as intrahepatic cholestasis of pregnancy (ICP), is the most common pregnancy‐specific liver disorder. 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!). (after months of discomfort) Anyway, glad you don't have to go through that. All twin pregnancies delivered above 28 gestational weeks in West China Second University Hospital from January 2013 to May 2015 were included. On the positive side, if creams/sprays are making the itching feel better it is unlikely to be OC - nothing stops that itching! 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. If you have medical concerns, please seek medical attention; if you think your problem could be acute, do so immediately. 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 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. Will it go away, because I'll end up mad if I have to put up with this for the next seven months!! and this website from the US.  |  The profound itching on the soles of my feet and palms of my hands drove me absolutely demented. I know that the same oversight cannot happen again but I’m feeling really very anxious now. Review of a challenging clinical issue: Intrahepatic cholestasis of pregnancy. I was induced at 37 weeks. Thanks as well efmach. USA.gov. 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 am being monitored by consultants this time and having blood taken once a month. 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). I feel like I have to keep telling them my priority is a healthy baby. 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. To comment on this thread you need to create a Mumsnet account. susanita Mon 31-Mar-03 15:36:51. Obstetric Best of luck - I'm sure you'll be absolutely fine. is there no end to the misery of pregancy? Try wrapping your hands and feet in cold towels and plastic bags before you go to bed, and don't overheat the room. It seems from looking at some internet info that itching on the hands and feet can be a symptom of OC and it can start as early as 2nd trimester. 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. The aim of the present work was to determine maternal and fetal outcomes of intrahepatic cholestasis of pregnancy (ICP) in twin pregnancies. Obstetric cholestasis is a disorder that affects your liver during pregnancy. doi: 10.1002/14651858.CD000493.pub2. Do you have questions about creating positive bathroom habits and routines? itchymoms. I'm 18 weeks. In the UK, it affects about 7 in 1000 women (less than 1%). Hi, 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). Wondering if they will bring forwrad the induction? Apparently this brings down the level of bile acids in the blood. Cholestasis is more common in the last trimester of pregnancy when hormones are at their peak, but it … Role of bile acid measurement in pregnancy. They "think" you have OC! HHS Incidentally, the itching started much earlier in this last pregnancy at about 22 weeks. When you have experienced something like obstetric cholestasis in the past it really is hard to get over. NIH I’m 32 weeks pregnant with 2nd baby. [Clinical practice guidelines of the Team of Experts of the Polish Gynecological Society: management of the intrahepatic cholestasis of pregnancy]. Sorry to ramble on, I’m just a little scared now I’ve reached the final stages. Recent research suggests that the pathophysiology may reside in mutations in genes that code for bile acid transporter proteins. Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, cholestasis of pregnancy, jaundice of pregnancy, and prurigo gravidarum, is a medical condition in which cholestasis occurs during pregnancy. Good luck. Thanks prufrock, the itching has stopped and the rash has gone so I guess it was an allergic reaction and I don't have OC. The symptoms get better when your baby has been born. . It's on my face and neck, arms, legs, back and bottom. Maybe I'm being neurotic but I woke up this morning with a rash on my arms and legs and itching. It affects around 0.7% of pregnancies in the UK 1 and typically presents in the third trimester. The OC Support and Info line is 0121 353 0699. BJOG. The baby was OK and it looked like they were too short staffed to do an immediate induction. I just remember that incredible itch that wouldn’t let me sleep, scratching myself until I bled and I’m not looking forward to the high probability that it will happen again. Theres more information here , For me, the itching started at about 20 weeks and tended to be tops of arms, chest and back. This site needs JavaScript to work properly. 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