The purpose of this article is to raise awareness of a condition that may affect pregnant women, and can have a life-threatening affect on the unborn baby.
My first pregnancy was farily straight-forward and I was expecting nothing out of the ordinary during my second - with my little
girl just 10 months old when I fell pregnant, I didn't have much time to think about it! When I was about 36 weeks pregnant, I started to develop really itchy skin. I had seen my midwife on the Friday, it was now Monday and I wasn't due to see the midwife again until I was 38 weeks. At first I didn't pay too much attention. I put it down to the fact that my skin was dry, like in my first pregnancy, and that I had been taking too many relaxing baths.
After a few days, it began to get worse and worse. When I visited people like my Mum and a friend, they ended up going off to find moisturiser to help calm my skin down. Still I carried on without paying most notice. My little girl was 19 months now and kept me busy. Plus I was using my maternity leave to try and get the house tidy (didn't happen!).
Well, by the time the midwife appointment rolled around, I was coping with the itching but it was waking me up at night, and particularly infruriating if I was hot. I also had very dark urine, despite drinking lots of fluid. I had a niggle in the back of my mind that somewhere I had read something about itchy skin not being good, but I hadn't got round to looking it up online, and none of my pregnancy books mentioned it. At the midwife appointment I thought I would say something and fully expected to be brushed off with "Oh, you're pregnant, these things happen." I thought that as I was so near my due date, the itching would probably stop when I gave birth and so there was nothing to be done. I was quite surprised when the midwife took a blood sample and said it would be sent off, although it was probably nothing to worry about.
My blood had been taken on the Friday and I had heard nothing by Tuesday, so presumed that everything was fine. Surely if there was a problem I would know by now? Wednesday morning I woke up tired as I had been sleeping badly for a while, and was just taking myself off to bed as my daughter was at nursery. The phone rang and I was told by the hospital that my blood results were back and I had high levels of something or other and I should come in. When I asked if I would come home afterwards, the answer was cagey and I realised probably not.
My Mum came down to the hospital with me whilst I raised my other half from a meeting. He wanted to wait and see what the outcome was before leaving work, and so Mum and I set off. At hospital the baby was monitored and seemed fine - nice strong heart beat. I was then told that I was suffering from a condition called Obstetric Cholestasis, whereby my liver was releasing bile salts into my blood. This was what was causing the itching, but worse than that was that the salts would cross the placenta and could be poisoning the baby. Apparently, most women develop OC by 26 weeks and are then monitored and given drugs until they can be induced at 36 weeks - the earliest normally considered as safe. I was now over 39 weeks pregnant. There is a 15% increased risk in stillbirth to women with this condition and I was getting worried.
I had my blood levels tested again for one of the two substances that they can get a quick result on. The second would take three days to get back, which was why I hadn't heard earlier (apparently my first blood sample hadn't been sent off until the Monday after my midwife appointment...) and we couldn't wait that long.
I was allowed home to sort out a few things whilst my blood was analysed, and returned later to be induced, as my levels were still too high. Fortunately everything happened pretty quickly and my son was born fit and well. I lost a fair amount of blood due to the fact that another side effect of OC is poor blood clotting, and felt absolutely terrible, but atleast my baby was healthy.
Please do not underestimate the seriousness of anything that seems unusual druing a pregnancy. Having since looked online, I realise how lucky I was. For more information, view here. The article is clear and helpful, and the comments section reveal other, sometimes tragic, experiences.
As a final comment, following the birth, some doctors may offer the mother a liver function test to confirm that they were suffering from OC and what the current situation is. As obstetric cholestasis is linked to hormones, it may well be that I will suffer itching on a monthly basis. I now have a Progesterone Only Pill (POP) contraceptive prescribed to try to alleviate this, as increased levels of oestrogen may again affect the liver.
(April 2006) (
