Pregnancy cholestasis

[TrishWSU]

I am about 33 weeks and have been going UP up til now but I think I may have this condition. I've looked at a few sites, and I have all of the symptons they list: constant itching of the hands, arms, feet, and soles, general unwell feeling, loss of appetite and nausea, insomnia.

Starting about a week ago I have been itching badly and I'm developing a bumpy rash on my hands, arms, legs, and neck. My itching is mainly on my arms, hands and legs and it's pretty intense, and for the last week or so I really haven't had much of an appetite. Every time I do eat I get an upset stomach afterwards {like I want to throw-up or I'm going to have diaherra} plus I've been really tender in my upper right abdomen about where the liver is located. Of course Aidan also sits on my right side and usually has his butt jammed up in my ribcage, so that could be the cause of the tenderness. I also read on one site that insomnia is common with ICP and I have had the most random sleep schedule lately. I'll sleep for about 3-4 hours then be wide awake, stay up for about 5-6, then go back to bed for another 3-4 hours. Unless I take a sleeping pill I can't stay asleep for longer than 4 hours and at this point with my dd I was sleeping 9-10 hours a night plus taking a 2-3 hour nap everyday.

And of course I read a scary statistic that says that 10% of untreated cases of ICP result in stillbirth. So now I'm really unsure what to do. Obviously I don't want to do anything that will endanger the baby, but at the same time I don't want to get thrown into the over medicalized freak out mode and do a bunch of unnecessary monitoring and the early induction that is given as pretty much the only treatment option. That is completely the opposite end of the peaceful UP/UC we have been planning, but of course the health of the baby is the most important thing.

I guess I'm trying to find out from a natural minded birth professional stand point how worried should I be about complications from this condition? Is there anything I can do on my own to minimize the chances of harm to the baby? Will getting the blood tests and NSTs every week that I read are the usual treatment actually help reduce the risks?

Sorry if I'm rambling! I have so many conflicting thoughts right now!

TIA

[heartandhandsdoula]

This is not from a MW but an ICP mama. generally there is no rash with this...have you researched pupps? If you still think it is ICP stay off of all fats, processed foods, pesticides etc etc anything that your liver will have to work hard to process. I ate loads of applesauce, oatmeal and broccoli! Yes the chance of stillbirth is higher after 38 weeks but from stories that I have read and from a perinatologist that I saw the baby doesn't show signs of dying, baby just dies so there is nothing that can be done to stop it, or show that it is going to happen. It is scary, I was induced at the hospital with dd1 at 38w and at home with ds2 at 37w. My liver levels were about 3x higher with ds than with dd. It gets worse each time. One thing that would bring relief to me for a short time was gold bond lotion and I think it had menthol or something similar in it, it was in a green bottle, but it would cool my skin for a few minutes. So sorry that you're going through this, it is miserable. have you been to itchymoms.com?

[TrishWSU]

Originally Posted by heartandhandsdoula

This is not from a MW but an ICP mama. generally there is no rash with this...have you researched pupps?

At first I thought about PUPPs mainly because that is the only pregnancy rash I've heard of, but everything I've read on that says it usually starts on and stays mainly on the stomach. Mine started as itching, and the bumps started showing up after I scratched, which I read was common with ICP itching. And the more I scratch the more bumps show up {but it's so hard NOT to scratch!}

I will definetly cut the fat out of my diet as much as possible. Unfortunetly I have been horrible about eating well this pregnancy. I didn't have anything even remotely close to this with my DD's pregnancy.

Another thing I just read is that mothers with ICP often experience epigastric discomfort, which I have had-big time! I have acid reflux as it is so I expected it to get worse during pregnancy, but it has been almost unbearable recently and even Zantac doesn't help.

Guess it's a good thing I like oatmeal! It might become my main food for the next few weeks.

I'll check out that site you mentioned. Thanks!

[Romana]

I'm not a birth professional. But isn't there a blood test you can take that will diagnose the condition - to show liver function, bile acids, elevated liver enzymes, etc.? For myself, the first thing I'd want to do is try to determine whether I really had it or not. From my reading (I was actually just looking at this the other day for some reason), it sounds like it would be unusual to have a rash. So, particularly with conflicting symptoms, I would be looking for some more concrete information. FWIW, I hope you don't have it.

[TrishWSU]

Oh yes, I'm going to start calling OBs this morning {I don't have a civillan GP or and OB-I just got out of the Army} to see if I can get in for the blood tests. I'd be so happy if this turned out to be just some weird skin irritation! I guess I should change the rash part...it's not really a rash, it's just bumps that have shown up from me scratching so much, which I read can happen with ICP.

Kassie, one thing, when you say you had your ds at home at 37 weeks did you go into labor on your own or did you try to 'naturally' induce at home? I can see how an induction is benefical with ICP but I would love to avoid a hospital induction.

Here's to hoping I'm just being a hypochondriac!

[heartandhandsdoula]

Yes my MW helped me induce at home with lots of cervical massage and stretching, water breaking, homeopathy and lots and lots of breastpumping!! But, this was my second so she was much happier to do it knowing that I had a successful induction with #1.

You can get a test done, but it has to be ordered by a HC provider, I don't think it has to be an ob though if you don't want to see one. Also, if you are going to induce I would start with lots of borage oil on the cervix which makes the itching worse but helps soften your cervix. Also try not to take the zantac b/c it has to go through the liver. Let us know how it goes.