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Case study:obstetric cholestasis

MagazineApril 1995 (Vol. 6 Issue 1)Case study:obstetric cholestasis

Last year, when I was pregnant with my second child, I started itching all over my body, particularly on my arms, hands and feet

Last year, when I was pregnant with my second child, I started itching all over my body, particularly on my arms, hands and feet. It began a couple of months before my due date and was terrible. I scratched until I bled and couldn't sleep.

I looked up "itching" in my pregnancy books and leaflets, but the only advice from these was to wear loose clothing and use oils, which was no help at all.As a practising acupuncturist with some medical training, I knew that itching could be a sign of a liver problem, so I asked "the expert", my antenatal doctor. "No, it's not," he said again, "It's just one of those things. Try bicarbonate of soda in your bath." In hindsight, I wonder why I accepted his reassurance so readily, but I did. I gritted my teeth and waited for the end of the pregnancy.

At full term, my daughter was stillborn. As far as the medical profession was concerned, it was one of the 50 per cent of stillbirths which are unexplained. However, 10 days after the birth, I read an article about a liver problem of pregnancy called obstetric cholestasis. The main symptom of this condition is itching! I dashed to the doctor for a liver function blood test, which turned out to be abnormal, and which did not return to normal for several more weeks. It was confirmed that I had suffered this condition. If it had been diagnosed earlier, I would have been delivered early and my baby would have been saved.

I want to share my experience with other mothers to warn them about this condition and to say never trust the so called "experts" they are not always up to date with current information. J R, Birmingham.....

Thank you for sharing your tragic story. A recent letter in the BMJ (January 28, 1995) suggests that half of unexplained stillbirths in Britain may be caused by cholestasis of pregnancy, characterized by generalized itching. More evidence that you need to be your own best expert to control your own health.

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