obstetric cholestasis, info needed

I've just heard that a friend who is 34 weeks has been sent to the
hospital as she has "a liver disease" or may have, all info I have in
2nd hand and I'm obviously concerned for her and her baby.

Dh spoke to her on the phone at the weekend and she said she was
itching, but she had some tablets and they made her drowsy and were
helping her sleep, so I assumed they were antihistamines, though I
didn't think antihistamines would have helped with either puppps or
obstetric cholestasis and didn't really think much more about it.

The news today is her midwife has sent her to the hospital, so I'm
wondering if there are any tests that would usually be done at an
antenatal appointment such as BP, urine dip etc. that might indicate it
was cholestasis? Or whether it would just be the itching that caused
the midwife to be concerned? Or course the itching could be a red
herring and it could be high BP and protein indicating PE and/or HELLP.
I think the policy here is to induce cholestasis cases at 37 weeks.

I'm surprised how anxious I feel about this, much more than I have
about anything relating to either of my own children and we've had
scared with them antenatally and worrying times with Nathanael in his
first year. This is my friends first child and she is 39 and has had at
least 2 miscarriages, for those of you that pray, please can you pray
for her (and if you have a moment, for me too!)

Cheers

Anne

"Anne Rogers" wrote in message
Dh spoke to her on the phone at the weekend and she said she was
itching, but she had some tablets and they made her drowsy and were
helping her sleep, so I assumed they were antihistamines, though I
didn't think antihistamines would have helped with either puppps or
obstetric cholestasis and didn't really think much more about it.

The liver problems is what is causing the itching and it's not probably not
antihistamines that help with liver itching. Allison, DD1, with her liver
disease from birth was put on phenabarbital for the itching caused by liver
disease. This is what I got from a website concerning OC.

For reasons that are not fully understood bile salts that are normally
excreted by the liver build up in the blood and cause intense itching of the
skin, particularly on the palms and soles of the feet.
Symptoms are most severe during the 3rd trimester, although they sometimes
occur earlier, and in many cases itching is the only symptom.

Mild jaundice can also occur, but in many cases it does not, and as a degree
of itching is often associated with a normal pregnancy the diagnosis of OC
is sometimes missed.

OC rarely has any long-term consequences for the mother and the itching
usually disappears within a week or two of delivery, but if the condition
goes undiagnosed the risk to the fetus of premature labour and stillbirth is
greatly increased.

A planned early delivery at between 35 and 38 weeks will generally avoid
these complications, which is why a correct early diagnosis is so important.

The condition tends to increases in severity with subsequent pregnancies,
making even earlier delivery of the baby necessary, and there is an
increased risk of it occurring with twins.

Many of the symptoms that may be associated with Obstetric Cholestasis, such
as nausea and vomiting and physical and mental fatigue, are common in many
normal pregnancies, but blood tests of liver function (LFT's) and bile
levels (Serum Bile Acid Test) will usually lead to a definite diagnosis.

--
Sue (mom to three girls)

Hi Anne,
A dear friend of mine had OC in pregancy last year. She was 35 weeks when
diganosed, was due to be induced at 37 weeks, but had baby spontaneously at
36.5.

It was a scary time, but once in hospital she and baby could be carefully
monitored and treated.
We found these webpages helpful at the time:

http://www.britishlivertrust.org.uk/...cholestasis.as
p

http://www.patient.co.uk/showdoc/26739184/

Baby Jack is now 1 year old and has never had any complications. His mum
stopped itching right after the birth and liver function went back to nomral
quickly.

Hugs,
Serenity

Anne,
No experience, but you, your friend and her baby will be very much in my
thoughts.

--
Amy
Mum to Carlos born sleeping 20/11/02,
& Ana born screaming 30/06/04
http://www.freewebs.com/carlos2002/
http://www.babiesonline.com/babies/a/ana%5Fj%5F2004/
My blog: http://spaces.msn.com/members/querer-hijo-querer-hija/



"Anne Rogers" wrote in message
ups.com...
I've just heard that a friend who is 34 weeks has been sent to the
hospital as she has "a liver disease" or may have, all info I have in
2nd hand and I'm obviously concerned for her and her baby.

Dh spoke to her on the phone at the weekend and she said she was
itching, but she had some tablets and they made her drowsy and were
helping her sleep, so I assumed they were antihistamines, though I
didn't think antihistamines would have helped with either puppps or
obstetric cholestasis and didn't really think much more about it.

The news today is her midwife has sent her to the hospital, so I'm
wondering if there are any tests that would usually be done at an
antenatal appointment such as BP, urine dip etc. that might indicate it
was cholestasis? Or whether it would just be the itching that caused
the midwife to be concerned? Or course the itching could be a red
herring and it could be high BP and protein indicating PE and/or HELLP.
I think the policy here is to induce cholestasis cases at 37 weeks.

I'm surprised how anxious I feel about this, much more than I have
about anything relating to either of my own children and we've had
scared with them antenatally and worrying times with Nathanael in his
first year. This is my friends first child and she is 39 and has had at
least 2 miscarriages, for those of you that pray, please can you pray
for her (and if you have a moment, for me too!)

Cheers

Anne

thanks for the replies and info, we're still not sure if my friend does
have OC, but it seems highly likely, it does seem however that her
midwife majorly overreacted and mishandled things on Thursday, rushing
her off to the hospital for almost no reason and really panicing her.
They scanned the baby on Friday and it was fine, they estimated it as
97th centile for weight, they will scan her liver on Monday. The plan
is to deliver when she is 37 weeks, which is now 2 weeks time,
obviously the big risk now is that an early induction fails, but when
it's a truly necessary induction, that's just a risk that has to be
taken. It might turn out to partially be a blessing in disguise, my
friend is a nurse and was quite keen to do a homebirth as she knows
what doctors are like, but her husband was not keen at all, also she's
been struggling a lot with back and pelvic pain (not SPD thankfully),
DH saw them both today and they seemed quite calm and happy that things
were being managed, which is a change from the panic of last week,
unfortunatly I wasn't there as I had a nasty accident on Friday so was
laid up at home :-(.

cheers

Anne

thanks for the replies and info, we're still not sure if my friend does
have OC, but it seems highly likely, it does seem however that her
midwife majorly overreacted and mishandled things on Thursday, rushing
her off to the hospital for almost no reason and really panicing her.
They scanned the baby on Friday and it was fine, they estimated it as
97th centile for weight, they will scan her liver on Monday. The plan
is to deliver when she is 37 weeks, which is now 2 weeks time,
obviously the big risk now is that an early induction fails, but when
it's a truly necessary induction, that's just a risk that has to be
taken. It might turn out to partially be a blessing in disguise, my
friend is a nurse and was quite keen to do a homebirth as she knows
what doctors are like, but her husband was not keen at all, also she's
been struggling a lot with back and pelvic pain (not SPD thankfully),
DH saw them both today and they seemed quite calm and happy that things
were being managed, which is a change from the panic of last week,
unfortunatly I wasn't there as I had a nasty accident on Friday so was
laid up at home :-(.

cheers

Anne

Glad to hear things are better with your friend,
and I hope it all goes as smoothly as possible
for her. But bummer about your accident. What
happened?

Emily

was coxing (steering a boat and yelling at rowers) in a bizarre form of
racing known as "bumps" invented by Cambridge undergraduates in the
1830s because the river is too narrow for racing side by side,
basically all the crews start in a line and the aim is to crash into
the crew in front of you. Obviously if you catch up with the crew in
front you are supposed to stop as quickly as possible, but the crew
that caught us neglected to do this meaning I took the full speed of
their boat in my back, sort of squashing and twisting me up between
their boat and ours, resulting in a sprained ankle and a sore and
bruised back and neck. Ironically I had very similar injuries not long
after Nathanael was born, but from falling down the stairs.

Anne

Anne Rogers wrote:
was coxing (steering a boat and yelling at rowers) in a bizarre form of
racing known as "bumps" invented by Cambridge undergraduates in the
1830s because the river is too narrow for racing side by side,
basically all the crews start in a line and the aim is to crash into
the crew in front of you. Obviously if you catch up with the crew in
front you are supposed to stop as quickly as possible, but the crew
that caught us neglected to do this meaning I took the full speed of
their boat in my back, sort of squashing and twisting me up between
their boat and ours, resulting in a sprained ankle and a sore and
bruised back and neck. Ironically I had very similar injuries not long
after Nathanael was born, but from falling down the stairs.

Yikes! I hope you heal quickly. How is the hip pain going?
I hope this hasn't aggravated it.

Emily