We spent 3 days there under a UV light, pushing IV fluids, and nursing around the clock to try to bring them down. Management of Intrahepatic Cholestasis of Pregnancy: New Guidelines from the Society for Maternal Fetal-Medicine. A little over a year later we moved back to Michigan near my family. To sign up to the latest Rare Disease Day news! By 12:45, my doula had me standing at the edge of the bed, leaning over and rocking my hips through contractions. Symptoms of ICP typically start from around 30 weeks of pregnancy, the NHS states, although it is possible to develop it as early as eight weeks. Intrahepatic cholestasis of pregnancy (also called ICP or cholestasis of pregnancy) is the most common liver condition that happens during pregnancy. My OB didn’t seem concerned, as it is only indicative of the cervix ripening – not necessarily labor being close. They were still elevated upon discharge, but were down to normal at my 2-week check-up. My husband took a nap on the sofa, and we had a shift-change with the nurses. My very last one was on a Friday. 5 minutes later, the cute charge nurse that I loved came jogging in and performed the last check, “Honey, you are almost done. To diagnose cholestasis of pregnancy, your pregnancy care provider will: 1. I checked into Triage at about 6:30PM, only to be told I should have gone to L&D, who told me I belonged at Ante-Partum. My baby boy was 1 month old! Perform a physical exam 3. That’s how Intrahepatic Cholestasis of Pregnancy (ICP) felt for me the first time. That’s not how it ended for me. Apparently, most women take a bit longer to get to this point than I did. The date was set for August 28th to come in and start with Cervadil the night before. I can only imagine what it was with my first baby. It affects the normal flow of bile, which results in itching that can vary in severity and type. Woman can expect to experience itching that begins on the palms of their hands and soles of their feet, dark urine, pale stools, Upper Right Quadrant (URQ) pain, sleep disturbance, & potentially jaundice if the numbers get high enough. For women who have experienced ICP in one pregnancy, the risk of having it again in subsequent pregnancies is 50 to 60 percent, according to the … (Little did I know this was making it worse!). The main symptom of ICP is severe itching in the absence of a rash. I got to the hospital, checked into L&D. I’m lucky enough to know what I do now to help advocate for other moms to get tested, and share my story so they understand the importance of being tested. I was at my moms watching “A Baby Story” with her. I still felt a little leery of the information, but went on with my day. He was so quiet when he came out, but his eyes were open and he was alert. All of my 24-week AFP’s were all cleared, and even my chronic hypertension was completely under control for the first time in the last 5 years. My doula said that this was likely transition, and that we were probably getting very close now. Cholestasis of pregnancy causes intense itching, primarily on the palms and soles of the feet, though the itching can spread to other parts of the body. Then the doctor walked in. Two pushes later (only three contractions total) Milo David Honza was born at 1:34pm. Intraheptic Cholestasis of Pregnancy (ICP) At around 35 weeks pregnant I read about a condition known as Obstetric Cholestasis (OC) or now more commonly known as Intrahepatic Cholestasis of Pregnancy (ICP). Watching the show, so much made sense. With all my symptoms and general miserable feelings, they started giving me twice weekly NST (non-stress tests). Cholestasis of pregnancy is a liver condition that most commonly arises in the third trimester, but can happen as early as 8 weeks. Ursodeoxycholic Acid (UDCA), also known as Actigall or Ursodiol or Urso is currently the front-line medication for the treatment of ICP. I have had two ICP pregnancies. There was no bloody show, but it was definitely my mucus plug on the bath tissue. After the first push, she said, “You are pushing great, but you are giving me little pushes. I had gotten out of bed to use the potty. He weighed 7 pounds even, and was 20 inches long. She believed me! I had her about 8 hours later, born into heaven. My ICP Story of Loss and Survival. I, of course, called my mother to tell her the good news. I wanted to make sure that my blood pressure stayed under control, so I didn’t want to stew over this for very long – I needed the peace of mind. So, I got up at 6 the next morning, went in for my labs, before heading to work. ICP is associated with higher rates of intrauterine fetal demise (IUFD) also known as stillbirth. From then onward, I had weekly ultrasounds (biophysical profiles), as well as non-stress tests twice weekly. I wanted to labor at home, come in toward the end, and avoid all interventions. Everything was moving along without further incident – baby was measuring well, amniotic fluid levels were good, and he was handling the NST’s like a champ. She said that she didn’t want to take any chances. For the next few weeks, it spiked back up to a 17 at his 2 week appointment, then dropped down to a 16 and 15 at consecutive weekly appointments. I guess you could say that I had a completely normal pregnancy…up until the beginning of my third trimester. Share this article via facebook Share this article via twitter Share this article via messenger. Itching usually occurs on the hands and feet but can also affect other parts of the body.Cholestasis of pregnancy can make you extremely uncomfortable. ICP is a serious liver disorder which is caused by a build-up of acid within the body. I was ripping skin off my legs and arms. They wanted to take me to a Triage room to check and see if my water had actually broken, but when I turned to follow the nurse, a doctor walked by and said, “Nurse, her pants are wet. Tags: ICP Pregnancy loss, Intrahepatic Cholestasis of Pregnancy, 2021 ICP Care 501(C)(3) All Rights Reserved Site Design by Madison & Mi. We were induced at 34+5 this time. On the following Monday, I was contracting pretty good when I woke up. At my next appointment they drew a ton of labs, and I got another ultrasound to confirm everything was still healthy and growing. At my appointment the following Friday, my doctor entered the room with a very sheepish look on her face – as if she were ready to apologize for something. All the sudden, I saw myself on the screen. Mothers and sisters of patients are also at higher risk of developing the condition, proving that there is a definite genetic predisposition. After about ten minutes of this, I was struck with the overwhelming urge to bear down and push. I knew instantly what had just happened, and looking down to see a toilet bowl filled with pinkish, bloody fluid confirmed my hunch. And you know what? It is uncommon, affecting 1 in 140 pregnant women (0.7%). At 20 weeks we got to learn that our baby was for sure a boy! The itching is what had tipped her off, as she is one of the only 2 doctors in the practice who recognize this disease for what it is. We tested early on and got a baseline for my bile acids levels. New doctors again, but with a better history of my issues, we were diligent in testing and assessing all symptoms I showed. (I did not have a bag packed yet, since I thought we were still at least 2 weeks out from the induction, and over a month from my original due date.) Silent Auction with Holiday gifts and Vacations to support ICP Care! They told me to push through it, so I did. They had to suction him a lot, since he was early and born so quickly that he wasn’t able to clear out his own mucus plugs in his nose and throat on his own. She was ripping her skin off from her fanatical itching! Milo struggled with his bilirubin levels all through the first month of his life. Milo turned 4 months old on 12/19/14, and he is doing well. Since I had not yet had my Strep-B test, they stared me on the 1st of three bags of Ampicillin, just in case I was positive. Pedigree studies identified familial aggregation of cases in more than one generation, also documented by others in Europe. 9 women share their pregnancy scare stories. There were two pediatric nurses – one with the nursery, one with the NICU – just in case he needed help breathing after delivery since he was over a month early. I also have a 60-90% chance of developing ICP again in future pregnancies, as well as with use of any hormonal birth control. My BA didn’t want to behave. This time, I will bring a baby home with me. This time my Bile Acids levels were 150+ on 2000 mgs of URSO. I also talk about my ICP pregnancy stories and treatment protocol with all 3 pregnancies. I talked to my mom and other trusted family members. My girl is a trooper. Another nurse came in and disconnected the IV line from the hep-lock, when I started to bear down again. One little speck could trigger an itching session that lasted all night. I also called my doula to let her know the situation. We also observed a 40% recurrence rate of ICP in multiparous women but with a nonuniform variability in date of onset of pruritus during pregnancy, its severity, and the laboratory abnormalities. So, with everything packed up, I called my mother (who lives 3 streets over) and my Grannie (who lives 5 hours away) to give them a head’s-up that we were headed to the hospital. Take her to a Labor Room.” The liver is the largest organ in your body. Still in labor, they said I could still deliver her on my own, since it seemed like my body was doing it anyways. They confirmed she had passed 24-48 hours prior to my going into labor. Additional research is necessary in this area since some pregnancies appear to be at higher risk than other pregnancies with Intrahepatic Cholestasis of Pregnancy. Everything was perfect. I was able to spend an hour with him and attempt to nurse before they took him to the nursery – husband in tow. The figure for the percentage of women for whom Intrahepatic Cholestasis of Pregnancy will recur in future pregnancies is 60% or as high as 90% for severe ICP. I stopped worrying about it all, until I noticed that I had lost my mucus plug at 35 weeks + 2 days. While it is a time of joyous anticipation, the journey up to delivery for many pregnant women is riddled with several health factors that need expert examination and treatment, so as to ensure that both mother and child are fine. So they got me set up in Labor Room #8. When asked if we wanted an autopsy, I said yes, of course! The bile acids were 14 umol/L. Posted October 23, 2018. ICP, which stands for intrahepatic cholestasis, is a … I knew so much more having my last two babies than I did the first time. He weighed 10lb 10oz at his appointment at the end of October, & 13lb 2oz at his December appointment so he’s gaining weight like a champ. I was shocked that I had progressed that much, and quickly text my mother, grandmother and doula. You are 100% effaced, baby is down and engaged, and you have only a tiny lip of cervix left. Doctor confirmed what I had felt, we had lost our sweet girl. He was due on 1 January 2016, but due to my bile acid results and a decrease in movements the medical team who had been monitoring me every week (from 18 weeks) and then every other day in my third trimester set an earlier date for a planned section. So, I’m “high risk” because of my age AND for having such a late term stillborn. Ask questions about your symptoms and medical history 2. ICP is associated with higher rates of intrauterine fetal demise (IUFD) also known as stillbirth. This was in the year 2000. And it wasn’t. This time, I’m older and wiser and can advocate for myself and my baby. She couldn’t sleep, she was exhausted. Have you ever thought you were going crazy because of something your body is doing that no one else understands? I was confused and scared, this being my first pregnancy. The itching can be bothersome to severe itching and is often worse at night. When the word “Pregnant” showed up on my ClearBlue pregnancy test one afternoon in January, I just about flipped my lid. Everyone was shocked, as only girls really run in my family – so I got to break the curse! Finally, one of them said, “let’s get the doctor in here to be sure ok.” This dread just came over me. She asked a few questions, before telling me that I needed to come in for fasting labs first thing in the morning – they wanted to draw a liver function panel and bile acid measurement. This may lead to Vitamin K deficiency. To submit your own story to the site, click here . Can we get a nurse for a check in here?” However, she went into labor before the results came back. What was funny about it was that there was no rash or skin discoloration of any kind – so I was baffled. My liver enzymes were still elevated in the 48 hours after delivery, so we had to stay an extra night. I had a 1st degree tear, which the OB put in two stitches, only because it had torn a blood vessel and she wanted to control the bleeding. Throughout my pregnancy I had gained close to 60lbs. Then I felt a small gush of fluid with the pressure and I panicked. The entire pregnancy week in the future, they started giving me little.... Having called into work to be at higher risk of developing the,... 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