Obstetric Cholestasis

Anna - posted on 04/03/2009 ( 9 moms have responded )

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Hi, I am interested in hearing from Mums who had Obstetric Cholestasis - especially if you have had it in two or more pregnancies.

I had Obstetric Cholestasis from about 33 weeks with my first pregnancy, which wasn't recognized until it developed into pre-eclampsia at about 36 weeks. As a result, my son was induced 2 days later at 36.5 weeks. He was a happy and healthy 2900g. I had very few concerns about subsequent pregnancies as I was lead to believe that the pre-eclampsia was the more concerning problem of the two and that I was unlikely to get it again.

However, 31 weeks into my second pregnancy I was itchy again and got myself checked out, only to discover that I had extremely high bile acids (like over 600). They tried medication, but the levels kept increasing to over 1500! So, my daughter was induced at 31.2 weeks, weighing 1700g. She spent 6 weeks in intensive care and that time was the hardest and worst time of my life!! However, she is now 6 months old and so healthy and happy. She has had no complications or illnesses due to her prematurity - we were so incredibly lucky.

I have always wanted three children, but I am terrified that with the next pregnancy that Obstetric Cholestasis will be even worse, with an earlier onset, meaning a higher risk to the baby. I feel so guilty about wanting another one, too - shouldn't I be happy with the two beautiful children I already have?

Did anyone else have these feelings about subsequent children? What have you decided to do? Has anyone carried a baby to full term after similar experiences to mine?

Just curious to know what everyone thinks!

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Bubblefairy6 - posted on 06/04/2012

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Hi ladies, I'm posting from New Zealand and joined the circle to discuss OC. I also got it just after 30 weeks into my third pregnancy.I had never heard of it and did nothing about it initially(as I thought the itching was normal) until I couldn't bear it anymore and brought it up with my midwife. Well, from that visit, it was straight to the Medlab to get bloods, which resulted in a Liver function blood count in their hundreds, as opposed to the normal count of 40. From here I was admitted to hospital, induced around 36 weeks. It was all very scary, away from the family and my other children at such a "nesting" time. I must add though,to my surprise, that with all the research I have done, no tests have been done or can show if there are any effects to worry about with my daughter in her future, will she get it in her pregnancies, is her liver ok?? I have been left to document all events myself for her safety later. They said it would go away after giving birth, but this is not necessarily the case I'm afraid. I have since been for surgery to remove the Gall Bladder, as I continued to get sick after her birth, went completely yellow, fighting for my life and again in hospital and also, away from my newborn. The liver failed so badly, it did an entire job on my biliary system. It turned into pregnancy related Pancreatitis. I am still having bloods done and my digestion system and nutritional lifestyle will never be the same. I found the medical profession quite vague with all of these procedures, I recieved a false sense of hope, I guess, regarding the resolution of the whole thing, but will not complain, as we are both alive!!! :) She is turning 1 this month and what a big year it has been! My advice is to report any itching at the first sign to your GP or midwife, and SHARE with other mothers/ to be !!! Given the risks of future pregnancies, I have decided to have no more and currently take the Depo Provera injection for contraceptive to balance out the hormones. I congratulate and admire the ladies who decided to have more, as I too would love more, but cannot bear the thought of going through it again or taking the risk, especially if they were to get worse. The information I was given state that once you have it, the chances of stillbirth go up 40%, more than I'm prepared to risk :(
I hope this helps a little bit, I've never posted on comments before but I really just wanted to join in, say hi and share the experience and wonder if anyone out there has experienced the same. At least if we can share the experience, we may find out more than the doctors know! :)
All the very best to anyone looking into it and take NO chances...and all the while, I thought the itching was just change in the soap or washing powder!! Seems harmless, but get it checked asap! Thanks, Raquel.

Rebecca - posted on 01/27/2012

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Hi. I had similar problems and decided to get my gall bladder removed. It was the best decision I made. I had much less stressful pregnancies after that.

Michelle - posted on 06/04/2013

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I also had oc. it started around 6 months with awful itching. It never would stop. Blood work confirmed I had oc. my daughter was born at 36 weeks by c section. I would love to have another child, but am afraid that it will happen again, and be much worse

Emily - posted on 01/11/2013

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Hi everyone,im a bit late for this thread but nevermind! I have 1 very lucky baby boy! I developed oc at 27wks, despite horrendous itching the midwife refused to do blood tests for oc telling me that it was a very rare condition. I ended up in day unit of maternity hospital where they tested blood and confirmed i had oc. I was given ursodeoxicolic acid,vit k and aqueos cream with menthol. From then on i went to hospital every week to be monitored and have bloods. It was a horrible time and awful as each week the bile acid levels just got higher and higher.they eventually told me that they would induce me at 38 wks. However baby was breech and by chance was given an appointment at 36 wks to turn him. I went in on the day and they put on the monitor before turning him. The machine started bleeping and a midwife ran in and pulled the emergancy cord. The babys heartrate was failing.the next minute i was being rushed into theatre where i had an emergancy c section. My 4 week old baby was 6.10!! I was so happy he was okay, though he had swallowed meconium. The hospital staff said theyd never seen anyone have a cs that fast! Basically the placenta had started to fail due to the bile acids. If i hadnt had that chance appointment that day it could have been devestating. I wish there was more research on it, but unfortunataly there isnt much! All experiences are different. Mine wasnt great. Some outcomes are heartbraking. Always ask questions if your unsure, demand a blood test if you begin itching. And try to enjoy your pregnancy! This will be my only baby , but i wouldnt change him for anythng. Im just glad hes here. :). I was full of questions and never got the answers i wanted! So just post if u want to ask anything.x

Mandy Jane - posted on 10/05/2012

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Hi I'm new to this site and have suffered the with same condition. I have 3 children, 2 girls and a boy. I've had Obstetric Cholestasis with all 3 of my pregnancies. After having my first daughter 2 wks early weighing 6lb 2oz(being told it can cause premature labour) I was worried about it coming bk if I was to have another baby so went and seen my doctor and he told me it was unlikely to happen again, so went a head and fell pregnant for my second daughter, it came bk and was really bad with blood test reading over 1000,so was on vitamin k and Ursodeoxycholic acid medicine which really helped. I had to be induced 3 wks earlier as the itching and blood test results was really bad, my daughter weighed 6lb 11oz. Then fell pregnant for my son and yet again it came bk and went through the usual of blood tests,scans, check ups ect, I had to be induced 4 wks early for my son,weighing in at 5lb 14oz. All my children, even though on the small side were healthy little things with know problems after birth. I'm with a new partner now and we have talked about having a baby together and have talked about the problems I've had with my pregnancies but we are thinking of taking the chance to extend our family. I know the signs to look for and the treatment that is there to help with it, my only main concern is if I have to be induced early again next time round and how early. I've always wanted 4 children and being with a new partner who doesn't have children of his own would be the icing on the cake so we will just have to see what happens when the time comes and cross fingers that its not as bad 4th time round. I know the itching is really unpleasant but to create a new life with my new partner and share it with him,then I'm willing to take the risk,as I know what to expect. Hope my story helps in some way.

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Anna - posted on 04/13/2011

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Hi Angela, I just found this post after all this time! You posted almost a year ago, in response to my post of over a year previous to that...

I did end up having another baby. She's turning 1 on Saturday. I did develop Obstetric Cholestasis again, this time from about 34 weeks. However, I had been put on Ursodeoxycholic acid prophyllactically (before any symptoms) from about 31 weeks (I pestered my obsetrician, who eventually referred me to a gastroenterologist, who agreed to try it). I believe this made all the difference - my enzyme levels remained within safe limits (abnormal, but not dangerously high), until my baby could safely be delivered at 37 weeks. She's an angel, I'm so glad I decided to risk it, although it was not an easy pregnancy. I was very nervous for the entire eight months, having monthly, fortnightly and then weekly blood tests, as well as foetal monitoring in the last few weeks. Not fun, but worth it in the end.

I wonder what you ended up deciding to do?

Best wishes,

Anna

Angela - posted on 06/14/2010

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Anna,

I went on line and search for "pregnancy after cholestasis" and somehow I ended up reading your post. So I immediately joined Circle of Moms just because I wanted to reply to you. I don't have an answer, on the other hand, I was looking for one myself.

With my first pregnancy I started having symptoms of Obstetric Cholestasis on the third trimester, I literally still carry scars from scratching my skin off. I went to full term with that pregnancy, it went undiagnosed, it is a miracle that my baby girl was born and the only complication was that she passed some meconium. I know I had the Obstetric Cholestasis on my first pregnancy because early in my second pregnancy the symptoms started again and this time (different hospital) they caught it, I was put on medication (Ursodeoxycholic Acid) and on my third trimester I was to have a stress test monitor every other day to check that the baby was ok. I was induced at 36 weeks after an amino to check that the lungs were fully functioning. I have, as well, two amazing little kids, my daughter is almost 4 and my son is 2 1/2. Therefore my question. Should I get pregnant again? I would love to have more kids, I love my little ones and I gladly spend all my energy in their growth and well being. I will of course consult it with my doctor but I was kind of wondering since you posted this over a year ago, if, you did have another child? or if there is any one out there with a similar situation.

Thanks so much and good luck!

Valerie - posted on 04/03/2009

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Anna,

I didn't have Obstetric Cholestasis but wanted to say that all of us who have had premature babies all have concerns about future pregnancies and having more premature babies.



We had conceived our twins via IVF and have another 3 embryos in cryostorage. I was 35 at the time. We knew at my first ultrasound at 11 weeks that I was pregnant with twins. I had a complicated pregnancy starting with a placental abruption at 16 weeks (put on restricted activities), gestational diabetes at 20 weeks, at home bedrest by 22 weeks for an incompetent cervix, hospital bedrest at 28 weeks, 7 weeks in the hospital going in and out of labour on my own, by week 34 I had dilated to 6 cm (they were just waiting for my water to break or for there to be a complication with one of the twins), at 35 weeks they discovered one of the twins had developed Intrauterine Growth Restriction and I had to be induced ASAP. Lily weighed 5 lbs 1 oz and Patrick weighed 3 lbs 15 oz (basically he had stopped growing at 33 weeks due to a damaged placenta). We spent 12 days in a Level II NICU "feeding and growing".



The twins are now 19 months actual and doing great. Our plan is to wait another couple of years before deciding if we will go back and try with the 3 embryos that we have left. Like you, I have concerns and have decided to discuss them with my obgyn BEFORE we get pregnant again. I'll need to lose some weight before I get pregnant again. I was overweight to start with and only gained the recommended 40 lbs for a twin pregnancy and lost the pregnancy weight right away.



I think that having an OB and/or Perinatologist (a high risk OB who specializes in premature births) who is familiar with your medical history, and can discuss what you can do to minimize your risk factors and have a plan in place BEFORE you get pregnant.



For me, that means if we do get pregnant again, no lifting anything over 5 lbs (caused the placental abruption), at home bedrest for most of pregnancy (due to history of incompetent cervix) (not likely to prevent it but hopefully slow it down), losing weight will help with the Gestational Diabetes but I am at high risk to get it again. We will also have to plan for full-time childcare for the twins as Hubby is out of town during the week and if I do end up hospitalized again, it will be in the city over an hour from home.

Anna - posted on 04/13/2011

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Hi Angela, I just found this post after all this time! You posted almost a year ago, in response to my post of over a year previous to that...

I did end up having another baby. She's turning 1 on Saturday. I did develop Obstetric Cholestasis again, this time from about 34 weeks. However, I had been put on Ursodeoxycholic acid prophyllactically (before any symptoms) from about 31 weeks (I pestered my obsetrician, who eventually referred me to a gastroenterologist, who agreed to try it). I believe this made all the difference - my enzyme levels remained within safe limits (abnormal, but not dangerously high), until my baby could safely be delivered at 37 weeks. She's an angel, I'm so glad I decided to risk it, although it was not an easy pregnancy. I was very nervous for the entire eight months, having monthly, fortnightly and then weekly blood tests, as well as foetal monitoring in the last few weeks. Not fun, but worth it in the end.

I wonder what you ended up deciding to do?

Best wishes,

Anna

Angela - posted on 06/14/2010

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Anna,

I went on line and search for "pregnancy after cholestasis" and somehow I ended up reading your post. So I immediately joined Circle of Moms just because I wanted to reply to you. I don't have an answer, on the other hand, I was looking for one myself.

With my first pregnancy I started having symptoms of Obstetric Cholestasis on the third trimester, I literally still carry scars from scratching my skin off. I went to full term with that pregnancy, it went undiagnosed, it is a miracle that my baby girl was born and the only complication was that she passed some meconium. I know I had the Obstetric Cholestasis on my first pregnancy because early in my second pregnancy the symptoms started again and this time (different hospital) they caught it, I was put on medication (Ursodeoxycholic Acid) and on my third trimester I was to have a stress test monitor every other day to check that the baby was ok. I was induced at 36 weeks after an amino to check that the lungs were fully functioning. I have, as well, two amazing little kids, my daughter is almost 4 and my son is 2 1/2. Therefore my question. Should I get pregnant again? I would love to have more kids, I love my little ones and I gladly spend all my energy in their growth and well being. I will of course consult it with my doctor but I was kind of wondering since you posted this over a year ago, if, you did have another child? or if there is any one out there with a similar situation.

Thanks so much and good luck!

Valerie - posted on 04/03/2009

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Anna,

I didn't have Obstetric Cholestasis but wanted to say that all of us who have had premature babies all have concerns about future pregnancies and having more premature babies.



We had conceived our twins via IVF and have another 3 embryos in cryostorage. I was 35 at the time. We knew at my first ultrasound at 11 weeks that I was pregnant with twins. I had a complicated pregnancy starting with a placental abruption at 16 weeks (put on restricted activities), gestational diabetes at 20 weeks, at home bedrest by 22 weeks for an incompetent cervix, hospital bedrest at 28 weeks, 7 weeks in the hospital going in and out of labour on my own, by week 34 I had dilated to 6 cm (they were just waiting for my water to break or for there to be a complication with one of the twins), at 35 weeks they discovered one of the twins had developed Intrauterine Growth Restriction and I had to be induced ASAP. Lily weighed 5 lbs 1 oz and Patrick weighed 3 lbs 15 oz (basically he had stopped growing at 33 weeks due to a damaged placenta). We spent 12 days in a Level II NICU "feeding and growing".



The twins are now 19 months actual and doing great. Our plan is to wait another couple of years before deciding if we will go back and try with the 3 embryos that we have left. Like you, I have concerns and have decided to discuss them with my obgyn BEFORE we get pregnant again. I'll need to lose some weight before I get pregnant again. I was overweight to start with and only gained the recommended 40 lbs for a twin pregnancy and lost the pregnancy weight right away.



I think that having an OB and/or Perinatologist (a high risk OB who specializes in premature births) who is familiar with your medical history, and can discuss what you can do to minimize your risk factors and have a plan in place BEFORE you get pregnant.



For me, that means if we do get pregnant again, no lifting anything over 5 lbs (caused the placental abruption), at home bedrest for most of pregnancy (due to history of incompetent cervix) (not likely to prevent it but hopefully slow it down), losing weight will help with the Gestational Diabetes but I am at high risk to get it again. We will also have to plan for full-time childcare for the twins as Hubby is out of town during the week and if I do end up hospitalized again, it will be in the city over an hour from home.

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