OBSTETRIC CHOLESTASIS

OBSTETRIC CHOLESTASIS

What is OC?

Basically this is a condition of the liver that usually occurs in the third trimester of pregnancy. It happens when there is a reduced flow of bile down the bile ducts in the liver.

This then causes the bile to leak out into the bloodstream. It is this build up of bile acids in the bloodstream that cause the symptoms. These include severe itching on the abdomen and hands and feet. This itching can often keep ladies awake during the night and keeps getting worse until your baby is born. It can become extremely distressing affecting your mood and concentration, probably due to lack of sleep.

The exact cause of OC remains unclear, although it is thought that hormonal and genetic factors can be partly responsible hence why OC usually occurs after 24 weeks of pregnancy when hormones are at their highest. This in turn affects how your liver is working.

It is thought that it runs in families and you may be more at risk of developing the condition if you have suffered with it in a previous pregnancy. Often the only symptom is that of severe itching however less common symptoms may include:

·         Tiredness

·         Poor appetite & nausea

·         Jaundice. Your skin may be tinged yellow and your urine may look darker than usual or your stools may look paler due to the increased levels of bilirubin in the bloodstream.

So can it be serious?

There is ongoing research into the seriousness of OC in pregnancy. Often the only risk to the mother is the unpleasantness of the itching but it is thought that it can slightly increase the risk of intra-uterine fetal death or stillbirth.

There is a risk of prematurity to your baby but this is mainly due to your obstetrician wanting to induce your labour if symptoms become too bad. Also there is a slight risk of your baby opening his or her bowels in utero which could lead to aspiration during delivery.

So how do I find out if I have OC?

Many ladies get some form of itching during pregnancy. This may be caused by the stretching of the skin and the appearance of stretch marks or maybe because your body temperature slightly increases during pregnancy. If however, severe itching is causing sleepless nights, you should inform your GP or midwife who will perform a blood test to check the levels of the bile acids and liver enzymes in the blood.

The first test is often performed to ascertain a baseline. Your blood test will then be repeated a week or so later to see if these levels are on the increase.

You will be monitored carefully throughout your pregnancy if OC is confirmed, and often an induction of labour will be arranged at approximately 37 weeks gestation. You will probably be prescribed some medication to help relieve the itching and given some cream to soothe the symptoms.

Generally things that you can do for yourself that may eleviate the symptoms, include trying to keep cool, so lower your heating thermometer in the house and wear loose fitting clothing. Try cooler showers and wear fewer clothes at night.

For further information you can go to www.ocsupport.org.uk

Please feel free to ask any questions relating to this any or any of my previous blogs. You can do this by leaving a comment on this blog or contacting me through my " confidential 1 to 1 live web chat" at http://www.justbambinos.co.uk/

I will be available for online midwifery advice chats most evenings from 8pm (GMT) so click on the icon on the home page to access the web chat and 'Ask the Midwife'.
If you enjoy what you read on these blogs please like our facebook page and follow us on Twitter or email us at justbambinos@gmail.com