Obstetric Cholestasis

Obstetric Cholestasis {OC} also known as ICP is rare liver disorder women can get in pregnancy. OC only affects 1 in 100 pregnant women in the UK. The main symptom for OC is itching. Although mild itching is very normal during pregnancy but if you feel that you are constantly itching or maybe just itching a bit too much than normal then you must phone your midwife and ask for a blood test as it could be Obstetric Cholestasis.

What is Obstetric Cholestasis?
Obstetric Cholestasis is a liver disorder that pregnant women can have, usually in the second trimester. If you develop Obstetric Cholestasis it means that the flow into the intestines reduces and the bile salts begin to build in the blood stream, which mean you will need to be put on medication.

Symptoms of Obstetric Cholestasis?
As said above, the main symptom for OC is itching. Mild itching could be completley normal but if you have any concerns then you should contact your midwife as soon as possible. The main places that itch with OC is your feet and hands. The itch comes without a rash and can be intense and constant. The itch might get worse as the weeks go by and you may loose sleep and your mood may change. Other symptoms could be:
- Jaundice
- Dark urine
- Loss of appetite
- Nausea
- Fatigue
- Depression

How Do They Diagnose Obstetric Cholestasis?
You will need to take some blood tests for them to check out your liver function and bile acids. In the UK your ALT's should be 33 or below. Your bile acids should be below 14 and anything above these numbers, that is when you will be diagnosed with OC.

How to treat Obstetric Cholestasis?
No one can treat OC during pregnancy. The only way OC will go away is by giving birth. You will be put on medication and should be given cream during your pregnancy to help your liver function blood levels and bile acid levels to decrease. The midwives should be monitoring you at least once or twice a week, as well as taking bloods weekly. Other ways to just help OC are:
- Wear loose clothing, nothing tight against your skin
- Try and avoid the heat, turn the heating down during the night as OC can get worse in the night
- Use the cream you midwife or doctor prescribes to you

Who is at risk of having Obstetric Cholestasis?
The people who are at risk of having OC the most are women who have mothers or other family member who have also had OC themselves. Women with multiple pregnancy and sometimes a woman can just have OC with no OC background through the family.

OC affects 1 in 100 pregnant women in the UK. If you have had Obstetric Cholestasis in your previous pregnancies then you have a great risk of having it again in future pregnancies. Some women can also be more sensitive to the hormonal change you have during pregnancy which can mean they can develop OC as their body experience an increase in estrogen and progesterone which can affect the liver.

What happens to baby during Obstetric Cholestasis? 
As said above, you should be monitored at least once or twice a week from when you are diagnosed with OC up until baby is born. You shouldn't be left to go overdue as the risk of stillbirth and other problems increase. More than likely you will be induced at 37, 38 or 39 weeks it all depends on your blood levels.

* I am not a doctor and I wrote this piece from my own experience and my own knowledge of Obstetric Cholestasis from the three pregnancies I have had. 

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