Intrahepatic Cholestasis of Pregnancy (ICP) – Don’t Ignore Itching!

I’ve been very luck with all my pregnancies, they’ve all been text book with no major issues and although I don’t especially enjoy being pregnant, I’ve never really had anything to complain about.

My last pregnancy was probably the most enjoyable of them all.   I had an anterior placenta (when the placenta is attached to the front wall of the uterus, or womb, rather than the more usual position on the back wall nearest the spine) which meant that I didn’t feel as much movement from the baby, and would often go all day without feeling one movement.  but I soon realised what was ‘normal’ movement for this baby.   I didn’t crave sweet things (which I had with the other pregnancies) and was eating a lot less than pre-pregnancy.

I’d just reached 32 weeks when I had the most unbearable itching, during the night, mainly on my legs and hands and I couldn’t sleep.  It felt like my skin was alive, I was literally scratching myself silly.   It would become more bearable during the day and I began to question whether or not I was in fact going mad (that’s not unusual during pregnancy!)  It became so bad that I had taken some Piraton to try and ease it and the next morning when I called to check with my Midwife that it was safe.  The Midwife wanted to take some bloods and also monitor the baby’s movement as it had decreased.  By the end of the day I had been diagnosed with Intrahepatic Cholestasis of Pregnancy –   which until then, I’d never heard of.

ICP is a liver disorder unique to pregnancy and is also known as Obstetric Cholestasis (OC).  Normally bile acids flow from  your liver to your gut to help you digest your food.  In ICP bile acids don’t flow properly and build up in your body instead.  There is no cure, but should disappear once your baby is born.   It affects 1 in 140 pregnant women in the UK,  I’m not lucky enough to win anything but apparently I am lucky enough to get this!

Although the symptoms of ICP were frustrating for me, especially the itching, they were essentially harmless.  However for the baby the main complication with ICP is stillbirth.  It’s not actually known why but is thought to be because of the increased bile acids.  I had blood tests twice a week to test my liver function and measure bile acids, scans to check the baby and monitoring of the movements.  I was given Vitamin K supplements (because ICP can affect your absorbtion of Vitamin K which is important for blood clotting) medication to reduce the bile acids and aqueous cream with menthol to ease the itching.

I had completely lost my appetite and had actually started to lose weight instead of putting it on (I would’ve seen this as a plus, if I wasn’t growing a baby!) I wasn’t ill as such, I just felt a bit unwell but more than that, there was the worry of whether I would actually get this baby here safely.  At every scan or appointment I would just think “the baby is ok right now, let’s deliver now, just in case”.

As soon as I reached 37 weeks  (the baby would be considered full term) I was induced as this was the safest option for the baby.  I had to be in hospital with an IV and constantly monitored.  I had a liver scan to check that no permanent damage had been done, which it hadn’t and would need no further treatment once I’d had the baby.

The birth was fast and uncomplicated but afterwards my mini man was taken to the NICU because of breathing complications, which was to be expected as he was premature.  I haemorrhaged and needed surgery.

The itching did continue for a few weeks, but nothing like what I had experienced when pregnant.  Six weeks after birth I had my bloods rechecked and my liver function was back up and rolling.

Once you’ve had ICP there’s a high chance of getting it again in subsequent pregnancies (between 60-90%) although it’s thought not to be so severe as the first time.  Research has shown that with medication, monitoring, blood tests and induction pregnancy with ICP carries no higher risk than a non-ICP pregnancy.

The Royal College of Obstetricians and Gynaecologists (RCOG) has more information about obstetric cholestasis, including what it means for you and your baby, and the treatment that’s available. You can also get information from the British Liver Trust.

The charity ICP Support provides information about ICP. You can also watch their video about ICP (OC) featuring mums and clinical experts.

Do Not Ignore The Itching!

 

 

Author: Allabouthurr

A thirty something mum of six mini humans and wife of one bumbling along in the world of parenting. Follow our ramblings on life as a larger family.

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