Intrahepatic Cholestasis - Baby delivery at 34 weeks

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Ainmom
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Posted: Thu Aug 04, 2011 4:48 am 
Post subject: Intrahepatic Cholestasis - Baby delivery at 34 weeks
Hi All,

I was dianosed with intrahepatic cholestasis at week 29 and Doctor has advised to deliver the baby at 34 weeks that was actually due on 4 Oct'11. Treatment with ursodeoxycholic tablets and Vitamin K has been effective in reducing the itching eversince diagnosed. However due to the uncertainity in loss of pregnancy in later weeks beyond 37 weeks, how safe is to deliver the baby at 34 weeks? and what consequences the prematured baby will have?

Appreciate some solution from community members. Thank you.
thatonethere
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Posted: Thu Aug 04, 2011 6:43 am 
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hia sorry to hear you have this condition, it's not pleasant, my friend had it too.

Have you had any growth scans to tell you how big your baby is and how much they weigh? At 34 weeks your baby will certainly be in neonatal for a few weeks but because they are prepared for you they will have everything ready. Your baby will probably need to be ventilated for a while but the chances are good and I hope everything works out well.

There's a premature baby section on here, I'm sure people can give better advice in there, my LO was almost full term when he was in SCBU so didn't need ventilating, CPAP or long term care but it was still quite a scary experience. There were a couple of babies in there who were born at 28 weeks.

Take care

xx
DL05
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Posted: Thu Aug 04, 2011 6:49 am 
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My baby was born at 33 weeks and didn't need ventilating (I'd had steroids) he was in scbu for 2 weeks but it was only so long because he had an infection, he was 5lb 12oz Shocked but they said to expect him to be around 4lb , he really thrived and quickly gained weight and the only thing he did late development wise was smile (12 weeks rather than 5-6) i'm sure the doctors will balance all the risks with the benefits though before deciding to deliver early and at the end of the day it's also your decision and you have to be comfortable with it , good luck xxx
Magdalen26
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Posted: Fri Aug 05, 2011 2:04 pm 
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Hi there - I also had Intrahepatic Cholestasis or Obstetric Cholestasis (OC) as it is also called last year. If you need further help, support and accurate information about Obstetric Cholestasis, go to www.ocsupport.org.uk

There is a forum where you can ask questions and chat to other mums with OC and also a facebook group, OC Support UK where there is lots of support.

It is good that they are giving you the Urso and Vitamin K. I would suggest that if the Urso is successfully lowering the bile salt levels, 34 weeks would be quite early to induce unless your levels were in the hundreds. The LFT levels are also important although the Bile salts are the ones that are thought to pose the greatest risk to the baby. Do you know your bile salt levels? My own view (I am not medically qualified in any way) would be that an induction around the 37 week mark would be sensible providing, you are being closely monitored including twice weekly bile acid bloods with a view to an immediate induction if the levels of bile acid were to dramatically rise.

There are many many variants with OC and many unknowns regarding it. This is why close monitoring and blood tests are key. With good active management of an OC pregnancy, there is not thought to be any greater risk to the baby than with a non OC pregnancy. That said, if you felt unwell or not right in anyway, it is always good to go straight to your day assessment unit to be checked. Do you mind me asking where in the country you are / which hospital?

I did have my baby at 35 weeks (induction was booked for 37 weeks) the levels shot up at 35 weeks so they gave me the steroids for baby's lungs and I was induced. She didn't need any special care and all was well. In my opinion, there is a quite a difference between 34 and 35 week even. If for instance you had your baby at week 35 / 36 he or she is likely to not even need any special care. I am not trying to persuade you either way, your instincts are hugely important and of course, the blood results will help you make an informed choice regarding the time of induction.

Do look at OC Support Uk, it is full of research papers and up to date information as well as lots of ladies in the same boat.

Wishing you well with it all. How are you finding the itching? Magdalen
mommyoftwo
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Posted: Mon Aug 29, 2011 3:33 pm 
Post subject: Intrahepatic Cholestasis
This is now my second pregnancy. My son will be three in March but when I was pregnant with him I started to experience the most intense itching all over. The weirdest places were my palms and my feet. I told my doctor and he didnt seem to think much of it... He just said my skin was stretching... Also, I am naturally an itchy person and I have sensitive skin so I though maybe I should switch to unscented perfumes and lotions. I did that but nothing worked. To make a long story short I itched for the last 5/6 weeks of my pregancy and as soon as he was born it went away. That's when I knew the itching was associated with my pregnancy. Now two and a half years later I am pregnant again, and the only thing I could think of is my traumatizing experience with the itching all over. That's when I googled "itching and pregnancy"... I came across IC... I read the symptoms and immediately I knew this is what I had.... I was very surprised to learn that less than 1% of women have this during pregancy. and also if you have it once then you will probably have it with your next pregnancies. Lucky me. I called my doctors office and spoke to a nurse to tell her what I though I had... She immidately said, "that has to do with the gallbladder"... suggesting that was not my problem. She spoke with the doc and he said it was PUPP...at the time I had no clue what PUPP was but after looking it up I called them back and said no, this is not what I have. With PUPP you ahve these nasty rashes, which I dont have... I asked to be tested for IC... a week later they called me back and said my levels were eleveated and I was right about my self diagnosis... "good job Sherlock" is what the nurse said to me... I know my body and I knew the itching was not normal... I itch more at night but once I fall asleep I am okay but if I have to wake up and use the restroom in the middle of the night its really hard for me to ignore the itching and go back to sleep... For now the doc is scheduling weekly stress test and told me to take some benadryl... All of the information I have read says I should be induced by about 37 weeks. I'm hoping this is what my doctor does because I dont want anything to happen to my baby. Luckily, nothing happened during my last pregnancy. I was 33 weeks and some days when I started itching... The itching was not very intense at all I just knew I had IC based on my previous pregnany. Now at 34 weeks and some days I have been diagnosed. My advice for anyone that is experiencing intense itching all over with no rash... TELL YOUR DOCTOR AND HAVE HIM/HER TEST YOU FOR IC... you know your body better than anyone else.
Jezebel
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Posted: Mon Aug 29, 2011 4:14 pm 
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Of course you must be worried but babies born at 34 weeks are generally fine. They are classified as moderately preterm apparently and the main problem is that they may need help breathing but this is lessened if you are given steroids before the delivery.
Mind you, I was born at 32 weeks without receiving steroids and I didn't even need ventilating. I was in an incubator for 2ish months but had no interventions and could feed ok. And this was 33 years ago before they knew that much about caring for preemies! Hope it all goes well. x
LauraG
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Posted: Tue Aug 30, 2011 4:38 pm 
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my dd was born at 35+3 and was 5lbs 9oz. she did not need to go to neonatal and stayed on the ward with me. after 2 mins of getting some oxygen wen born she was passes straight to me. she needed to be put in an icubator overnight to keep her body temp and needed something t keep her blood sugar levels up.

due to her prematurity she had failure to thrive due to poor suck reflex and has low muscle tone and valgus foot. she has delayed speech and generaly delayed overall. but she has no major health problems.

ur baby should be fine being born at 34 weeks.
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evettemoll
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Posted: Thu Oct 13, 2011 5:53 am 
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Having a baby is really a blessing!I'm happy for all of the mothers out here!Giving birth isn't that easy but some find childbirth an art.While I was browsing I have read that the performance artist Marni Kotak, 36,will soon give birth before a live audience at the Microscope Gallery in the Bushwick community of Brooklyn, New York. I find this topic a bit weird, but still something interesting to talk about. I've read several articles about this, please allow me to share it here.source article: Live birth performance art coming to New York gallery
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