intrahepatic cholestasis of pregnancy

  1. My daughter in law was diagnosed with this late in her pregnancy. She thought her itching was due to stress and her mid-wife agreed. (Her symptoms increased to the point where she was on Atarax to control the itching. She was to the point where she was using keys to try and scratch as well as bare concrete for her feet). The day before her scheduled induction she had severe nausea and vomiting. The next day when I heard about it as well as the fact that the baby was't moving, I told them to call their MD. She was admitted to the hospital with FHT present and rehydrated. 12 hours later she was started on Cytotec. Even before the Cytotec the baby never had a consistent baseline rate--was from 110 to 170. She had no results from the first Cytotec but evidently hyperstimed with the second application. Terb was given with no result and then MS.
    An emergency C-section was performed and the baby was born with apgars of 5-7. He ended spending the next 4-5 days in the ICN on dopamine first for renal perfusion and then BP support. It sounded like sepsis but nothing cultured out.
    He is fine now but all the MD's said that the ICHP had nothing to do with his problems---even thought two of the OB's I work with said there was a significant increase in risk to these infants. Does anyone have any experience with this
    Thanks
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  2. 6 Comments

  3. by   camrnhill
    Eileen,

    I know your original post is from 2001, however I am hoping that I might be able to assist in your confussion some. I have heard of Intra Hepatic Cholestasis (ICP), in fact I suffer from it myself. And yes, there is an increased risk to the infants from this disease. Unfortunately many doctors out there are still uninformed and no little about ICP so they tell the patients that there is no or little risk to the infants. I hope all worked out well for your daughter in law and the baby. And she should be aware that there is in increased risk of her suffering from ICP again with each subsequent pregnancy. In the future, if she has any more children there is a drug that she can take to help with the ICP (Actigall).

    If you need any more info let me know.
  4. by   webbiedebbie
    Wow, I just took care of a woman (postpartum) with this and fortunately her baby was fine. It was a few weeks ago and I don't remember what medication she was taking.

    I love that we are able to bring our experiences together this way!
  5. by   camrnhill
    Debbie,

    Was that your first patient with ICP? I know that ICP is a very rare disease only affecting 1/10000 women. In fact, had I not suffered from it myself I probably still would not know about it. However, after going through two pregnancies undiagnosed (the first time around) and miserable (both times) I did a lot of research and found out quite a bit. I am very happy that I did this research on my own as I am again pregnant and itching already. However, I now know about the use of Actigall and it is helping a lot. If I can be of any help in passing on info please let me know.
  6. by   webbiedebbie
    Yes, it was my first. I work nights. She wanted a sleeping pill. She said she wouldn't be so uncomfortable if she could sleep through it. I wish I could remember what she was taking for the ICP.
  7. by   webbiedebbie
    Yes, it was my first. I work nights. She wanted a sleeping pill. She said she wouldn't be so uncomfortable if she could sleep through it. I wish I could remember what she was taking for the ICP.

    We aren't allowed access to internet at work. I would have loved to be able to get the information that night about ICP.
  8. by   camrnhill
    From past experience, I can understand what your patient meant about being able to sleep. I personally never thought itching could so dramatically take over my life. However it did and does. Due to the itching, the woman can't get sleep. In fact I tore up a couple of sheets while I was itching in my sleep. It is plain awful. But thankfully there is now the use of Actigall which is helping a lot this go round.

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