cholestasis :(

[dsb76]

Just got a call from my Ob that my  labs are back and all the itching I've been having for past 2 weeks is indeed cholestasis.  He wants to schedule me for an induction (or c-section if they are still breech) at 36 weeks.  That's next week.  I have an appointment this Thursday along with my weekly nst and an ultrasound to discuss this but I'm a little freaked out.

I knew these babies could come at any time but I am suddenly feeling completely ill-prepared and scared.  Anyone else been through this?

I've read some of the old posts on this subject and I'm looking at itchymoms.com but there seems to be a lot of conflicting info out there.  :(

[Red Pajama]

I was tested and tested-- it was assumed at first that I had this, because I itched like crazy. It was never confirmed with the lab work they did.

I don't know if you've found any relief, but i found sun burn relief gel with lidocaine in it to be helpful in calming my itch.

As for the babies, do your research, work with your doctor, and make the best decision you can.

[~Adorkable~]

please go to http://www.itchymoms.com/ to read up in stuff.

i had a pretty impressive case of ICP last year when preggo. it is my strong opinion and the research supports me that 36 weeks is toooooo early to do something drastic like an induction or section. even my doc that were very jumpy said 37 weeks to help their lungs, who needs more issues right?

look around that site, it really helps you understand a lot, take a few big deep breaths, i went from panic to actually being pretty calm about stuff after reading a bunch. 

the lotion they talk about Sarna i think it is called really helps but wow it makes you really cold, be careful to not put it on too large of an area at once, i put it all over once and cried i was so cold and shaking from it.

there are good things you can take to support your liver, please think about taking them right away.

after all my researching how to prep my cervix for a natural induction or to be more prepped for whatever they wanted to push on me,  I ended up in spontaneous labor at 35w6d and gave birth vaginally 30 hours later (36w0d) with only 16 min of total pushing! and have blissfully healthy babies, you can do this! i think my body knew they were ready and i was done. they had no NICU time, something that stunned everyone since their age and tiny size. had it been a few days earlier i might not have been so lucky, had they come a week later I'm sure breastfeeding would have been tons easier as would other things as well

if you want to talk about anything I'm here for you, I'm thinking on another pregnancy and ICP is on my mind again, sigh

[dsb76]

Thank you so much for the reply.

Ultrasound and NST looked fine, babies are growing well.  Baby A had moved from frank breech to heads down when the tech did the ultrasound - but then in the 20 min waiting for the perinatologist to come in to take a quick ultrasound look she had moved transverse with her head on the opposite side of where it was last month!  At least it is clear that she has plenty of room.  Baby B is still breech but that is okay.

My OB is pushing for 36wks and the perinatologist seems to be in agreement.  I don't know if I am less argumentative about it since I am so uncomfortable - a large part of me just wants this pregnancy to be over.  I have another NST and an ultrasound for position on Tuesday.  If the ursodiol hasn't helped the itching by then I doubt I will be arguing  at all about delivering next week (if it has worked I might be singing a different tune.)   In the mean time I am also taking the dandelion supplements, the milkthistle and drinking nettle tea.  I have been using the sarna which is helpful I just wish it lasted more than 2 hrs so I could sleep.  I made the mistake of using it all over one night as well and while I shivered for 30minutes I did get relief afterwards for a bit.

Maybe I will go into labor naturally before Wednesday.  I'm thinking of doing some acupressure on Tuesday to get the ball rolling.  Trying to decide if I should do any thing else as well...  I think I am too swollen to have sex right now.

[~Adorkable~]

you sound like you are taking good care of yourself, hang in there

a few thoughts

if i were looking at a 36w induction i would also be asking for a steroid shot RIGHT NOW for their lungs, this also happens to be what my high risk ob considered standard practice, we did not give me one since we felt i could go 37w.

there are great ways to get your body/cervix ready for a induction that dont include sex, large doses of EPO right up next to the cervix held there by a diaphragm or a Instead menstral cup was the go to way to kick start things by my midwife, you can start taking it orally right now around 4000 a day minumim and save the vaginal dose (8-10 pills a few times a day) for the 72 hours leading up to an induction date. the more your cervix is ready the way way better chance you have.

also keep in mind that babies can still move a lot right now, mine were still flipping at this point (ended up both head down) and that even in mid labor they can flip, so a bad position on D day is not a automatic section, a trial labor to help things along is usually very safe and helpful. (it also has hormonal benefits for both you and the babies)

other than that, i would jut do you best to stay comfy and calm, I'm rooting for you

i was taking Benadryl (Diphenhydramine) to help with the itching, it is thought that it does not work on the main itch but is really helpful because anywhere you have scratched you have a secondary inflammation response that itches more and it does very much work on that.

[lesliesara63]

My cholestasis was also not confirmed by labs when I had it 4 yrs ago with dd2. It was horrendous & I would have done anything to have it over. The thought of giving up my homebirth was devastating though. Fortunately my water broke at 36+5 and she was born at home a few hours later. I itched for a few days afterward. I also itched for the first few weeks of my triplet pregnancy which really scared me. It did go away though and I did not have it again with that pregnancy. Gold Bond also makes a cream with menthol. If I put it on after getting out of the bath it made me really cold & shaking, but I could get to sleep. It didn't have the same effect if I put it on any other time. I took Benadryl basically to sleep for 4 hrs. Otherwise I was awake and scratching & feeling like a crazy person! Hang in there it will be over soon.

[dsb76]

Itchiing is improved currently but it is touch and go.  Hopefully I will be able to sleep the next 2 nights.

Babies are moving around like crazy.  Unfortunately at today's US while Baby A is heads down she has cord and hand between her head and my cervix.  Boo again.  So I am scheduled for a C/S on Wednesday.  My Ob will ultrasound again before surgery and is willing to try induction if positioning is better (and cord is out of the way).

I'm pretty disappointed but I don't think there is much to do at this point except keep my fingers crossed.

I am going to go to yoga class tomorrow and then hopefully have a prenatal massage and just try to relax.

[ShanaV]

I had cholestasis while pg with my twins ... It was awful! My ob also suggested delivering the babies at 35-36 weeks (after their lung development is confirmed). But we didn't even get that far because the day after I got the diagnosis my water broke.

Side note: My ob scared me so badly by saying that cholestasis can lead to "fetal demise" ... O.O That wording is just so scary!

[dsb76]

Thank you everyone.
We delivered by csection 2 beautiful and healthy babies last night. Audrey was 5 lb 3 oz is nursing great, Maxwell was 4 lb 13 oz is doing well though not as strong of a nurser (stilll doing great though).
I'm much less itchy, a little sad to have gone through surgery but otherwise a very happy mama.
I will post more when I have access to a computer.

[hergrace]

Congratulations on the birth of your babes.

[rinap]

Many many congratulations.

[mylilmonkeys]

Congratulations!!

[~Adorkable~]

What a huge congrats! I know the last few weeks must of been hard on you as they sure were when I when thru ICP, but I'm sure that soon it will hardly a blip on your wonderful path to mothering these two babies! So glad to hear that everyone is good, may the grow strong and cuddle often!

[dsb76]

This is cross-posted with my ddc

Audrey Elaine and Maxwell Zachary were born 11/9/11

Pictures:

I am home and doing well though exhausted, both babies are still in the NICU - having trouble with temperature control and being lazy nursers but both are improving and otherwise look great.  I'm hoping they will be home by the end of the week.
 

I had a c-section when it became clear with multiple ultrasounds that while Audrey (baby A) was heads down there was a pocket of fluid between her head and my cervix containing cord.  So no induction.  Part of me wishes I had insisted on waiting until 37 weeks or gotten a second opinion on the optimal time for delivery - but I don't know if I could have forgiven myself if I had lost one of these guys due to cholestasis.

Regardless - we are all doing well.  I feel like there are so many things I should be doing right now but it would probably be best for me to go to bed so I can get up in 3 hours to pump.

(oh - and it is wonderful not to itch)

[~Adorkable~]

now is the time to relax and enjoy being a mamma, please do your best to let the second guessing go, you did what was right at the time, that is all anyone can do