Intrahepatic Cholestasis of Pregnancy

Hey everyone. I want to post a post just about Intrahepatic Cholestasis of Pregnancy to bring awareness to this condition because its not well known at all. So please share this with any OBGYNS you know and anyone who is or wants to become pregnant so they know what to watch for. This is very serious and needs to get out there.

Intrahepatic Cholestasis of Pregnancy  is a pregnancy- related liver condition in which there are abnormalities in the flow of bile. The abnormalities in the flow of bile lead to a build up of bile acids in the mothers blood. This results in iching that can vary in type and severity. It is most common for ICP to begin in the last trimester, although it has been reported as early as a few weeks pregnant. The reason ICP is more common in the last trimester of pregnancy is because hormones are at their peak. ICP occurs in about 1 out of 1,000 pregnancies.

SYMPTOMS:



The most common symptom of ICP is itching. Itching is worst in the night in a lot of cases. It is often the ony symptom that a woman who suffers from ICP notices. It is usually more severe on the palms of the hands and soles of the feet but often Jaundice- Is the yellowing of skin and the whites of the eye. Although uncommon it does occasionally occur for ICP suffers.

Dark Urine- This is also a more common sign of Intrahepatic Cholestasis of Pregnancy... it could also be a sign of dehydration.

Fatigue, depression and loss of appetite are also symptoms of ICP.

Intrahepatic Cholestasis of Pregnancy can be diagnosedby two blood tests  a Serum Bile Acid Test (SBA) and a Liver Function Test (LFT).

There are very serious risks that are associated with Intrahepatic Cholestasis of Pregnancy. ICP is associated with premature labor, fetal distress, hemorrhaging in both the child and mother and also STILLBIRTH.

TREATMENT:



The most important two factors in the treatment of ICP are taking a medicine Ursodeoxycholic Acid (UDCA) which reduces the bile acids in the blood stream and also delivering the baby by 36 or 37 weeks is a crucial part in the treatment for ICP.

Here is a list on the management and other treatment for ICP:

- Vitamin K for patients whose PT levels are low!

- Steroids: They are good for increasing the probability of the babys lung maturity at birth. Also, it could help some of the itching that is associated with ICP by surpressing hormone production.

The things you should observe are as Follows:

- Serum Bile Acid level is one of the most important indicators of ICP.  The serum bile acid tests should be repeated at least weekly untill you deliver and again afterwards to make sure there is no underlying liver problems.

- The Liver Function Test (LFT) should be done once or twice a week as well. It's possible for an ICP patient with their Serum Bile Acid levels raised to have a normal LFT and still be at risk.

- Surveillance of your baby is very important but it cannot tottally eliminate the risk of stillbirth. You should have some or all of the techniques done twice weekly untill you deliver your baby. A biophysical profile, cardiotocography,a doppler flow study and ultrasound.

- Because ICP sufferers have a higher risk of vitamin K malabsorption, PT (clotting times) should be checked at least weekly as the delivery gets close and at the delivery to prevent maternal hemorrhage and Intra-cranial hemorrhage in the baby. It is vital for your newborn to get the vitamin K shot right after delivery.

- Early delivery as stated above is one of the most important treatments for ICP. Delivery no later than 37 weeks to prevent the risks that are associated with ICP. This goes for any case of ICP mild or severe, Bile Acids can triple in a matter of 24 hrs.

Things ICP mothers can do to help themselves:

- Drink lots of water. Water helps flush toxins out of our body.

- Lower stress levels, many woman with ICP notice that in stressful situations their itching increases.

- Lower fat intake: The less fat the less itching has been reported from ICP moms. This could be due to the fact that when you eat fats it prompts the body to secrete bile acids in the stomach to begin the digestion process which could mean more bile acids are entering the bloodstream.

- You should eliminate external irritants.

- Taking milk thistle and dandelion root are safe during pregnancy and have been proven to stregthen and benefit the liver. Before taking and herb or drug please consult your Dr.

- Sarna lotion many woman find sooting for the itching.

- It is very important that the woman that have ICP follow a diet that will help the liver during pregnancy. A low fat healthy diet is key.

If you get Intrahepatic Cholestatsis of Pregnancy it is common to develop ICP again in future pregnacys.
If you have itching during pregnancy please go get it checked out. Intrahepatic Cholestasis of Pregnancy is a very serious condition of pregnancy, while it is uncommon it still does happen. Dont risk your unborn babies life get it checked out. Itchymoms.com is the official website please check it out it is GREAT.
If you have any questions or comments please feel free to contact me at selesprincess@yahoo.com

2007

Heres my Rain!! Isn't she beautiful??? I know :) Heres my story. I have been with my boyfriend since I was 14 we always wanted kids but I knew if I got pregnant before I was 18 my dad would kill me so....we waited and when I turned 18 were like yep lets go for it and well it wasnt that easy it took me 2 years to get pregnant! Febuary 14th 2007 we were in Hobbs New Mexico since we were traveling to NM to look at houses thats where we wanted to move. The first night which happened to be Valentines Day we stopped in Hobbs and well thats the night our beautiful Rain was concieved....heres the thing when we walked out of the hotel that night to go pick up my mom who was gambling haha it was snowing OMG I should have known something beautiful just happened and on Valentines Day isnt that perfect....remember Im in San Antonio so Snow is a BIG DEAL we dont get it we dont see it we dont even hear about it haha so yeah thats the beautiful story :) So we found our house in Cimmaron NM and we came back to San Antonio for two weeks so we could get stuff ready and then my mom,sister and Eric drove us to NM and this was a weekend when we got there....around the middle of the next week I started feeling real ewwy....but I thought it was the elevation or whatever that we were higher so maybe me being so sensitive that was making me sick but as it went on I was all stomach sick I didnt throw up just felt like CRAP so then I was like I must have a stomach Flu by the next Monday I threw up that morning so we called b.c i mean it was uhhh and so i wanted to get some medicine or whatever pregnancy never even entered my mind because remember we were trying for two years....but sure enough they do those questions and they are like well we are just going to test you for pregnancy then like 5 minutes later they are like your PREGNANT!!!! Yep I know  REALLY?!?!?! YEA!!!! AWESOME!!!! So thats how we found out that I was preggers with my angel little did I know she was really my ANGEL! :( So around 3 weeks later we actually moved back to San Antonio because there was no hospital close and I was SICKKKK so since my dad was military and I was under 21 that was my insurance and so I had to go to a Military Hospital little did I know that would be the biggest mistake ever. So the pregnancy was awesome because me and my babygirl were good except of course the all day every day throwing up I couldnt even keep down liquids most of the time...they gave me meds but I think I only took two pills like the whole time for nausea because they didnt help so why take meds while Im pregnant you know?? On my birthday 21st I might add I got an u/s an extra one of my babygirl because I actually got a uti and the dr knew it was my birthday and since I really wanted an U/S we made a deal they could test my sugar you know that little pricky thing just to make sure and I got an Ultrasound DEAL!!! This was at BAMC not the other Hospital that I really dont even want to say or type or think the name of but since I was just going to the ER I could go to BAMC. So other than that everything was all good we got two fun Ultrasounds those 4d ones too one at 18 weeks and one at 28 weeks omg she was just sooooo damn cute in all of them of course!! At around 34 weeks I started getting itching around 34 weeks and I didnt know what it was at all but everyone I talked to didnt know either and my mom actually had a drs appointment and I asked there and he said he couldnt tell me because he wasnt an OBGYN so he didnt even want to take a risk in telling me the wrong thing you know?!?! At my 36 week check up I told my dr or whatever they make you see about my itching and I was like Im itching ALL over but espeically the palm of my hands and the soles of my feet, in between my fingers and toes. She looked at my stomach to see if I had stretch marks which I didnt  as she is telling me about the pregnancy itch ok well like I said I didnt have one single stretch mark I didnt even gain 10 pounds the whole pregnancy since all I did was throw up and really my stomach is what itched the least...but she went on to say it was just a pregnany itch NORMAL thing and to take cold showers, run lotion on and I could take bendryl.....so I go home and do that well I was waking up crying everynight all night and my boyfriend was having to run me multiple cold showers at night I was sleeping with ice packs under my feet and I would put them on my hands. I was using some oil that is out for pregnancy itching but nothing was helping so my 36 week appointment was on a Thursday by that Monday I couldnt take it all, all i was doing was crying I couldnt sleep at all b/c I was itching 24/7 so we call urgent care at THAT hospital and they tell me to come in so they can run blood on me...well my liver levels came back very elevated so the dr the only one who knew what he was doing was like your liver levels are high and we cant get your bile levels back for 2 weeks and the safest thing to do for you and your baby is you need to be induced right away...so hes like Im going to call up to Labor and Delivery and see if they have room available and he did and he said yep theres rooms ready so just go upstairs and you will be induced....and thats when all the b/s happened. So this is the 15th of October a Monday I go up there and right away pretty much tell me they arent going to induce me because they dont know for sure that I have Icp and even if I do its not that big of a deal Hello....if you are Drs you would know what ICP is and how serious it is and how I need meds which I didnt get and the baby needs to be out but yeah they werent real drs. So long story short from that day till the day I lost her Saturday the 20th they kepy putting my induction off...I went in Friday night and they did a nst well kind of  and Rain was moving like crazy and kicking the little thing litterally off my stomach and her hearbeat was over 180 for over 10 mins well we questioned them saying something doesnt seem right her heart is high and shes kicking like crazy well they said she is perfect and her nst was perfect and this is around 5PM 19th of October and they GUARNTEED me she would be good for 72 hours umm ok remember this is my first pregnancy I dont know anything about ICP Pregnancy anything so I beilve and trust the doctors by 5 the next morning the love of my life was gone. You can read more of my story on http://intrahepaticcholestasisofpregnancy.yolasite.com/ thats the site I made about Cholestasis and it has my story sorry I pretty much finished there I just dont want to go into everything at the moment but everythings on that page that I linked. OCT 20th 2007 was the day my life changed forever I lost my heart!