Doc pushing induction for cholestasis that I may not have

wigglegiggleworm

I am 35 weeks now and at some point around 28 weeks I noticed a mild itching in my feet. A quick search online made me aware of cholestasis and so I decided to mention this itching to my obgyn.

 She ran the appropriate test (a fractioned bile acid test) and only one of my bile acid levels was elevated by just .4 but my total bile acid number was something like 5.3 everything I read states that the level for diagnosing is 10-14... immediately after getting results she told me I would need to be induced at 37 weeks or sooner and I am very confused about this. I have had another total bile acid test done and am still in the normal range but she has me going to non-stress tests and ultrasounds twice a week. I am a very cautious person and understand that there is an increased risk of still birth with cholestasis but I am not really being shown reasonable medical evidence that I have it.  The itching I am experiencing never intensified to the horrific-scratch-yourself-open kind of itch that I have read about and so far I am not seeing truly abnormal bile acid levels.  I appreciate her caution with the NSTs and blood tests but I think inducing over itchy feet alone may be going too far... Should I push back? I know induction comes with it's own risks too... I'm not against it if it is actually medically necessary but I would like things to go as naturally as possible.

Has anyone else experienced this or anything similar?

kaylaraemb

Yes, absolutely push back!  I believe that your doctor should be 100% certain you have bile levels that are elevated enough to qualify for an induced labor before pushing the induction on you. You should make sure your not misunderstanding your doctor, & that there aren’t other factors in play that would indicate you need an induced labor at 37 weeks.  

I can’t speak from personal experience, but my best friend was induced in January because of her bile levels.  She was diagnosed with ICP around 34-35 weeks.  Her itching was so bad, she WAS scratching herself open & she had an incredibly challenging time sleeping because of the itchiness.  She was monitored/tested multiple times a week, and her levels continued to increase.  She was never scheduled to be induced until her levels were finally too high & deemed unsafe.  After that, she was induced the very next day.  She carried her baby to 37 weeks + 3 days.  Her doctors took every measure to keep her baby in her for as long as possible.  & I’m sure want your little one in there as long as possible too 😊

So, definitely ask questions & get answers from your doctors until you fully understand what’s going on!  Good luck!   

Cadg0986

I agree with PP, I would push back. I was induced at 39w with my first for a different reason and I wish I would have stood up for myself more. 

ILMomma

I have never posted here but I saw ur thread and I have to comment.  I had extreme itching around seven months which went away on its own after a week.  My doctor did the normal test and my bile level was 9.  She told me she would officially diagnose me if the medicine to stop the itching worked.  Since the itching went away without medicine she did not diagnose me.  To be safe I requested another blood test two weeks later and the bile lever had gone down to 5.  We never had another discussion about it.  I think you should definitely push back.  I did not want to induce if it was not necessary.  Your doctor is way too induce happy.