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obstetric cholestasis questions? Lock Rss

hi my name is leah,

i have had 3 misscaraiges and 1 baby, i am pregnant with my second baby, 22 weeks now.
my misscaraiges happened before the first trimester was over, but when i was pregnant with my daughter i went to full term, i was vomiting the whole way through the pregnancy and during the last trimester i was always scratching. this was always worse at night and was so bad i was deprived of sleep as i could stop the itch.
i complained about this to my gp and obsterition they both said that it was probably an allergy or midgies. i read in a book that it could have something to do with my liver and i mentioned this to them which in return they just laughed at me and said no it was normal. a week before my daughter was born my ob ordered blood tests and found that it was my liver, the iron was low and i had increased liver enzymes, i was also jaundiced. so 2 days before she was born my ob admitted me into hospital and started to induce me. my daughter was born on the day she was due. i ended up needing a blood transfusion. i also needed a few follow up tests to make sure i was ok again.

with this new pregnancy i have choosen a different gp and ob. and have told them about my troubles with my first pregnancy they said that they will monitor me more closely, but i have come to see that they arent monitoring me that close at all firstly should i make more appointments or not?

i did some research and came accross some info on obstetric cholestasis and have read into it and i believe that that was what the ob said i had at my follow up appointment with my daughter. i also read that it can happen again in a subsiquent pregnancy so my main concern is can it happen again? and should i be getting a second opinion if the doctors do not take any blood tests? what should i do if the itching starts again? i am vomiting almost every night with this pregnancy and starting to become very lethargic once again. this is how it started before, could this be whats happening again? as i said before i am 22 weeks and its gettting very close to when the itching started last time. i am so scared of going through that again, please help.
leah,
i too had osetetric cholestasis during my first pregnancy, and it too wouldnt have been picked up until i had read something about it..
was put in hostpital at 30 weeks, and no one could give me answers.. so think it might be no-one really knows enough about cholestasis.
i am currently 33 weeks pregnant this time and had very minimal itching, and have got the hospital to take blood twice which havent come back with anything. i think you should keep an eye on how you feel, and keep telling the dr's etc when you see them. i was told if it got to bad that i was to call maternity and they would organise a blood test asap, and also to have the baby and yourself monitored(mainly to make sure the baby isnt distressed).
i didnt have the vomiting with either of my pregnancy;s and dont think that is much to do with cholestasis, i think see how you go as unless you are severly itching they wont do anything. i wasnt put on medication till after 32 weeks and anything for itching didnt last for long enough, but i can say they will monitor you a few times a week if you do get itchy..
i hope that helped a little, dont be scared just relax an enjoy every other part of your pregnancy...
larissa

Hi,
Thank you for your enquiry. Cholestasis in pregnancy appears to be genetically linked more than one-third of women have a family history of the disease (e.g. mothers or sisters). When the condition occurs during pregnancy, it recurs in 60-70% of future pregnancies and occurs in every pregnancy of about 25% of affected women. However, the severity of Cholestasis may vary from one pregnancy to the next and may skip pregnancies entirely.
The classic symptom of cholestasis of pregnancy is intense generalized pruritus (itching). The itching usually begins in the third trimester, but may occur any time from before 20 weeks up until term. It ranges in intensity from mild to virtually intolerable. It is usually noticed first at night and then progresses to become constant. Though the pruritus is found throughout the body, it is often most severe on the palms and the soles. Insomnia often accompanies the itching and the patient may scratch her skin to the point it becomes excoriated (scratched and crusted over). After delivery, the symptoms usually decrease within 48 hours of delivery and disappear completely within 4 weeks postpartum. Cholestasis of pregnancy does not cause permanent liver impairment—once the baby is delivered, the liver returns to normal function. Cholestasis can cause some problems to the baby while pregnant.
If you feel that you are experiencing symptoms similar to your first pregnancy then you need to be checked over, even if you go to your local GP, he can perform blood tests to confirm the presence of the condition. If you do develop this condition, you do need to be monitored closely and your carers should see you more often. You may need to be admitted to hospital for close observation if necessary.
Best wishes,
Alex.
<a href="http://www.nswmidwives.com.au/">NSW Midwives Association</a>
Note: This information is not designed to replace that of your health professional.

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