Intrahepatic Cholestasis awareness

foxa319

hey all!

I've never started my own discussion on here but I've had some complications going on with my pregnancy that I wanted to share to bring an awareness about this diagnosis and symptoms. I'm 29.5 weeks now and just before 28 weeks I noticed I was getting a little more itchy than I had been previously. I had one night where I was up most of the night scratching at my feet especially.
I am an l&d nurse now but had previously worked with a lot of patients with gi problems and knew that itching on the soles of the feet is sometimes an early sign of liver issues. I called the dr the next morning and they had me come in for blood work asap. I had just had labs drawn at my 27 week appt and all of my liver levels had gone from normal to high and tripled in less than a week. They drew bile acids as well, another test that has to be sent out and normally takes 5-7 days to come back but is the definitive test for a diagnosis of intrahepatic Cholestasis of pregnancy. I was started on a medication called ursodiol before that test even came back bc my symptoms matched up pretty closely. My bile acids came back at 57 which is actually considered severe ICP! ICP is generally a 3rd trimester disease in which the bile flow from the liver is slowed and the bile acids spill into the bloodstream.

I'm extremely lucky that I go to the ob at the hospital I work at which is a high risk ob w a level 3 nicu and that my dr took my symptoms so seriously so quickly. If untreated this pregnancy disease can be fatal to the baby, with a risk of still birth after 37 weeks. It is still relatively unknown as to why this disease effects certain ppl, which is scary! I have a dr appt, an nst, bpp and labs being done weekly until I am induced around 37 weeks as long as the meds can maintain my bile acid levels and baby is still doing well!

I wanted to write this post so others are aware of this and don't brush off being really itchy as a normal pregnancy thing! We're all in our 3rd trimester now and this could pop up for anyone at anytime like it did for me! A lot of obs don't even take this very seriously bc it is still pretty unknown and unstudied which is scary! In 2 years as an l&d nurse I've only had 1 patient with this condition, and my high risk ob in a big city says they only get a handful of cases a year!

Sorry about the long post! And to sum it up, listen to your body ladies and if you feel something is off be pushy about it!!!!

alexam2012

I have been really itchy and worried about it but my doctors keep brushing it off. Should I insist they test me?

KaLikeAWind

Thanks for the info. Other than the itchiness, how else would we know to become concerned? Or is it just itchiness to excess? Cause I think everybody can be itchy sometimes, so how will we know to worry, or not?
Glad you caught it early! Hope the medications work well and all goes well for you and baby!

foxa319

Itchy on the palms of the hands and soles of the feet esp at night is the number one sign! Other symptoms include right upper quadrant pain, dark urine and fatigue. All I have is the itching though!

Serenamarr

I had serious itchiness only on my lower legs and only at night, that wasn't accompanied by any rash, dry skin, or redness. I told my OB about it because I knew this was a symptom of ICP and he immediately wrote up the order for me to have a blood draw to test for it. It turned out I did not have ICP, but the test was covered under my insurance and it really didn't hurt to check. If I hadn't asked, I know I would have worried and worried. As long as it is covered, there is no reason not to check it out if only to ease your mind.

lovethatcolosun

Glad you found out early and are on treatment. Thank you for the heads up on this I had no idea! Good luck with everything. Keep us posted in your progress.