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Intrahepatic Cholestasis of Pregnancy (ICP)


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Do you have a naturopath or herbalist you could consult with?

 

Dandelion is healing to the liver and can sometimes help.

No, I don't. I'm afraid my insurance would not cover that and I don't have the money to hire one. I had a feeling about this pregnancy from the beginning and that is why I didn't go with my homebirthing midwife (and good call on my part, she would have turned me over to a practice and hospital birth as well, especially due to this). This practice is full of midwives and a few OB's. It was an OB that picked up on this, even though I've complained multiple times about the unusual extreme itching and fatigue. She recognised it because she had it with her pregnancy also.

 

I have a store near here with herbals and homeopathics. Would they sell dandelion there? Would it be good as a tea or is it a capsule (wrong time of year for fresh pickings LOL!). Is it okay with reflux?

Edited by mommaduck
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I have had extreme exhaustion and itching in the last trimester with a few if mine and the drs just shrugged and said blahblahblah liver blahblahblah typical blahblahblah drink lots of water and no worry.;)

 

Most of the time the itching wasn't constant, but when it hit, it was like chicken pox or ivy - just could not not scratch it.

 

Yeah I was pretty darn tired, but really that is typical for me towards the end of a pregnancy anyways. I always get insomnia and even on the rare nights when I don't - I ache all over and can't get comfortable. So itching or not, it isn't like I'd be sleeping heavy or long anyways.

 

ETA: oh yeah most importantly, no complications whatsoever from it for me or baby.

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Thanks, Auntie M.

 

Martha, oy, it's been bad! And I've had it most of the pregnancy. It got brushed off till this particular OB. The website has been scaring me a bit. Particularly this part:

 

ICP poses several risks that are of great concern. ICP is associated with an increased risk for infant stillbirth (intrauterine death of baby), premature labor, fetal distress, and hemorrhaging in both mother and child.

 

I've been there before with an allergic reaction to a drug prescribed to me. And I just want to be able have this last baby safely. Did you deliver early? I was told they would be monitoring me more closely and was wondering what that would involve (?). I'm waiting for my bloodwork to come back, but the symptoms fit (only thing I haven't had is the depression...thankful for that!) I've had the fatigue, the itching (to the point of sores), dark urine, very small appetite (but thankfully I'm craving fruits/veggies/protein and not fats or sweets...which are the two things I'm supposed to avoid apparently). My insomnia is less than with other pregnancies though. I think my being tired has overridden that one and dh is working third shift, so he's not disturbing me.

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I had it when I was pregnant with the boys. It did not recur during my second pregnancy.

 

Topical treatments did not work at all. Eventually, Actigall was prescribed for me. It provided minor relief -- which was better than nothing.

 

The instant I finished giving birth to the boys, the horrible, torturous itching disappeared, as did the other pregnancy-related diseases I had. Poof!

 

I was told, and believe, that this condition had nothing to do with the boys being born prematurely.

Edited by RoughCollie
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Well, I don't know a lot about it as I am not a herbalist. I know quite a bit about some herbs but not so much about others, this is one I know a little about.

 

So there is my disclaimer. lol

 

We had one client early in my apprenticeship who started having some itching and her UA showed a small amount some liver stress. My partner (then preceptor) started her on the dandelion tincture and also had her see an OB. The dandelion helped and the OB didn't find anything to risk her out.

 

If they haven't said, I would ask at your next appointment if your UA is showing bilirubin or urobilinogen.

 

I did find this: http://www.gentlebirth.org/archives/puppp.html

 

Dandelion also listed on the website you posted, under treatment. They also mention milk thistle but I have read some conflicting information about that one so I wouldn't recommend it without talking to a herbalist (but great for lactation).

 

I looked in my Wise Woman Herbal book and she says (p102 under preventing jaundice): 10 drops of tincture several times a week

 

The tea would probably be effective. A tincture might be a little stronger though.

 

The dandelion might actually help with the reflux.

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Well, I don't know a lot about it as I am not a herbalist. I know quite a bit about some herbs but not so much about others, this is one I know a little about.

 

So there is my disclaimer. lol

 

We had one client early in my apprenticeship who started having some itching and her UA showed a small amount some liver stress. My partner (then preceptor) started her on the dandelion tincture and also had her see an OB. The dandelion helped and the OB didn't find anything to risk her out.

 

If they haven't said, I would ask at your next appointment if your UA is showing bilirubin or urobilinogen.

 

I did find this: http://www.gentlebirth.org/archives/puppp.html

 

Dandelion also listed on the website you posted, under treatment. They also mention milk thistle but I have read some conflicting information about that one so I wouldn't recommend it without talking to a herbalist (but great for lactation).

 

I looked in my Wise Woman Herbal book and she says (p102 under preventing jaundice): 10 drops of tincture several times a week

 

The tea would probably be effective. A tincture might be a little stronger though.

 

The dandelion might actually help with the reflux.

Thank you! I'm calling about my tests on Monday. Hopefully they will know then. That's why I posted the website also, because I know there can be conflicting information and I don't like doing things blindly. Bless you!

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Have you tried Earth Momma herbal teas? Several of them have dandelion in them and are safe for pregnant women. I LOVE my earth momma tea! It's yummy, especially in them cold nights it might not be a high enough dose to completely help, but either way it is a very healthy tea for pregnant and postpartum women.

 

ETA: I get mine at Whole Foods, but I bet most health stores carry it.

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Have you tried Earth Momma herbal teas? Several of them have dandelion in them and are safe for pregnant women. I LOVE my earth momma tea! It's yummy, especially in them cold nights it might not be a high enough dose to completely help, but either way it is a very healthy tea for pregnant and postpartum women.

 

ETA: I get mine at Whole Foods, but I bet most health stores carry it.

I will look for it. Right now I've been drinking Traditional Medicinals Organic Pregnancy Tea. I just looked and it doesn't have dandelion. So I will look for the other.

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I had extreme itching, fatigue, and dark urine with my first baby, 17 years ago. It wasn't ever diagnosed, but looking back I'm sure that's what I had. The itching was maddening and nearly drove me crazy. I've always had really dry skin, and I thought it was just worse than usual. I don't know if I even ever mentioned it to my doctor. I tried lots of different OTC lotions, and the only one that worked was Carmol 10, which contains urea. That helped enormously, although I still itched some. I don't think Carmol is made anymore, but you might try a different urea-containing lotion.

 

My baby was healthy, although she had horrible colic for 6 months. I don't think it's related, but I doubt if anyone has ever looked for an association.

 

I had two more pregnancies after her, and didn't have any itching with them.

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Thanks, Sue :)

 

Danielle, yes I had previa during the first half of this pregnancy. That did finally resolve itself (I tried to stay off my feet and no lifting). Having that resolved was a blessing. I'm still taking things easy. Doing a bit at a time and resting often. I can feel when I've been on my feet for too long as my stomach starts to stiffen up. Trying to keep stress levels down (difficult this week as my stepmother past away, dealing with homewrecker sending harassing texts to my sisters today, the day of the funeral, etc). Thankfully, I'm distant to all of the drama and am only offering comfort and advice via phone and FB.

Edited by mommaduck
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I haven't had it but Thing 3 has a cholestatic liver disease. Actigall is what is prescribed for itching and Urso sometimes helps with symptoms. You might also try to turmeric in your food. Warm baths are a bad idea - it will make the itching worse and so will getting hot in general. Just out of curiosity, are you able to get relief when you scratch the itch?

 

:grouphug: I hope all goes well. I will ask our priest to pray for you and the baby.

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I haven't had it but Thing 3 has a cholestatic liver disease. Actigall is what is prescribed for itching and Urso sometimes helps with symptoms. You might also try to turmeric in your food. Warm baths are a bad idea - it will make the itching worse and so will getting hot in general. Just out of curiosity, are you able to get relief when you scratch the itch?

 

:grouphug: I hope all goes well. I will ask our priest to pray for you and the baby.

I can't always get relief and when I do, it's very temporary. The itching isn't as bad as it was, but still there. Turmeric? I've never used it...on meat, veggies, or the starch?

 

(and thank you for the prayers)

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I can't always get relief and when I do, it's very temporary. The itching isn't as bad as it was, but still there. Turmeric? I've never used it...on meat, veggies, or the starch?

 

(and thank you for the prayers)

 

Tumeric added to rice makes a nice saffronish flavor.

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I can't always get relief and when I do, it's very temporary. The itching isn't as bad as it was, but still there. Turmeric? I've never used it...on meat, veggies, or the starch?

 

(and thank you for the prayers)

 

With Thing 3's disease they call the itching "the itch that scratches" because the itching is from the inside out and scratching doesn't do anything except damage your skin.

 

Turmeric is used in Indian food a lot. I believe it is an ingredient in curry.

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With Thing 3's disease they call the itching "the itch that scratches" because the itching is from the inside out and scratching doesn't do anything except damage your skin.

 

Turmeric is used in Indian food a lot. I believe it is an ingredient in curry.

Exactly. I'm embarrassed about how my skin looks. Thank heavens for clothes!

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As part off dd's OB rotation for her paramedic training, they went through a discussion of possible herbal remedies to be aware of that women might be taking during a pregnancy so if they were treating a mom in route, they'd know if there would be any possible drug interactions.

 

Milk Thistle and Dandelion were two that were considered common amongst herbalists for liver issues. She suggests that you check them out with your midwife before trying them as just because people take them for liver, that doesn't mean they are wise during pregnancy though they may also be fine. She does recommend lots of water and NO NO NO NO warm baths, no hot showers...stay out of the bath and keep the shower dialed down. Heat isn't good for your liver at this time. As a matter of fact, if they are called to the home of a pregnant woman with hepatic issues, this is one of the questions they ask.

 

Topically, she said to ask your midwife about the safety of using a carrier oil such as almond oil mixed with tea tree oil (so long as you have no allergy) and myrrh oil...myrrh oil is a natural "numbing" agent and can work a bit like sunburn spray on the skin...a respite from the itching feeling. But, she isn't sure of the mix...she's just heard a couple of OB nurses mention it to a mom that they transported that was having a lot of itching though hers was more eczema related, not hepatic. Anyway, just something to run past your mid-wife.

 

I'll be praying for you and little duck.

Faith

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As part off dd's OB rotation for her paramedic training, they went through a discussion of possible herbal remedies to be aware of that women might be taking during a pregnancy so if they were treating a mom in route, they'd know if there would be any possible drug interactions.

 

Milk Thistle and Dandelion were two that were considered common amongst herbalists for liver issues. She suggests that you check them out with your midwife before trying them as just because people take them for liver, that doesn't mean they are wise during pregnancy though they may also be fine. She does recommend lots of water and NO NO NO NO warm baths, no hot showers...stay out of the bath and keep the shower dialed down. Heat isn't good for your liver at this time. As a matter of fact, if they are called to the home of a pregnant woman with hepatic issues, this is one of the questions they ask.

 

Topically, she said to ask your midwife about the safety of using a carrier oil such as almond oil mixed with tea tree oil (so long as you have no allergy) and myrrh oil...myrrh oil is a natural "numbing" agent and can work a bit like sunburn spray on the skin...a respite from the itching feeling. But, she isn't sure of the mix...she's just heard a couple of OB nurses mention it to a mom that they transported that was having a lot of itching though hers was more eczema related, not hepatic. Anyway, just something to run past your mid-wife.

 

I'll be praying for you and little duck.

Faith

Thank you :) I'll bring these up to my OB. I didn't know about hot water being bad with liver problems. I have no allergies to those oils, but am careful with TTO because of the phytoestrogen. I'll double check the herbals with her first also...if for no other reason than so that she knows what I'm taking in case of an emergency (they usually find out the hard way about a patient taking an herbal AFTER a contrary reaction).

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My friend diagnosed herself. She was very near the end of her pregnancy, so they delivered as soon as they confirmed the diagnosis. She was fine, baby was fine. As I recall, she thought in retrospect that she had also had it with her first dc, as there was some issue at birth. Everything was fine with that one too, but there had been some sort of complication.

 

The itching drove her a tiny bit insane, though :-) Sorry you're going through this!

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Just saw this Mommaduck and I can contribute! I had this condition with my first two pregnancies (interestingly it didn't show up with #3 or #4 who is 3 days past due at the moment.)

 

You've already found Itchymom's and it is the most informative website. There is also a Yahoo group you can join to talk with other mom's who have experienced cholestasis. There is a link from the Itchymom's website I believe. That was very helpful for me when it was 3:00 AM and I couldn't sleep.

 

My first experience was a nightmare. I had to print off pages and pages of info off the internet to get myself diagnosed and by the time my midwife took me seriously I was 37 weeks and we had to induce. So I had about 6 weeks of complete misery before that.

 

The second time around I knew what to expect and the minute I felt the itching I got myself on Actigal/Ursodial and it helped tremendously although the itching didn't completely go away. It was bearable. We induced at 36 weeks that time. Both inductions went really well. We only had to have the midwife break my water and then I went into labor with no further interventions. The babies were completely healthy and the itching went away immediately after birth.

 

If this is what you are experiencing then follow the suggestions on Itchymom's. Taking Milkthistle would support your liver. Also, a lot of women have found that decreasing their fat and protein intake is very helpful because it reduces the stress on the liver from processing those foods. I found that to be true for myself. Some women have tried a liver supplement called SAM-E that is available at the drugstore. It's more like a detox than supporting liver function. I also used a lotion called Sarna that helped a little bit.

 

I hope that's not what you have! But if it is, it sounds like you have a doctor/midwife who is taking you seriously. That's half the battle.

 

I'd love to help if you have more questions.

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I have had it three times:confused:. With dd1, dd2, and ds2. The first time I had it it took weeks to figure out what it was. Apparantly it is very rare. The CNM I had at the time told me to take a benadryl:glare:. I was able to see a different CNM, and she ordered a liver panel, and with the help of a specialist I was given a med that elimenated symptoms and returned my liver function to normal. My numbers with her were very high before we figured it out. I had to take it until I delivered. I was induced and dd1 was 10lbs 7oz, and very healthy. With dd2, my CNM did several liver panels, and my levels were normal until I hit the third trimester. I was able to start treating it about a week after symptoms started. I was induced 2 weeks early because of cholestasis, and macrosomnea. dd2 was 8lbs 10oz, and healthy. With ds1 I did not have it until 2 weeks before he was delivered. I was once again induced early because of it. He was born 2 weeks early at 7lbs 9oz, and he is also healthy. I did not have it at all with my first. Oddly enough I do not know anyone else who has had it. The itch that it causes is like no other itch. It is horrible!

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I think I've seen Sarna at Wallgreen's. I have also ordered it over the internet. How far along are you? I think I was about 30 weeks before I started to have symptoms, but I've read many stories of women who start in the first trimester. Ugh. I've also read all the scary stories about stillbirth, but almost all of them have happened when the mother was either untreated or the baby wasn't delivered by the 37 week protocol. Please keep us posted about the results when you get them on Monday!

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Also, a lot of women have found that decreasing their fat and protein intake is very helpful because it reduces the stress on the liver from processing those foods. I found that to be true for myself. Some women have tried a liver supplement called SAM-E that is available at the drugstore. It's more like a detox than supporting liver function. I also used a lotion called Sarna that helped a little bit.

 

Yes, I have heard people talk about SAM-E and a low fat/protein diet as well. And there are prescription creams for the itching that seem to help for different people. I don't know what they are called. :confused: Itching in our house only happens when Thing 3 is overheated or has taken a warm bath, although Urso has helped quite a bit with that.

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Father of Pearl just pointed out a detail that I forgot. They think the reason people have itchiness is that there is bile in the blood. If you get too warm then it brings the blood closer to the surface of the skin which in turn causes the itchiness. This is somewhat theoretical but it is talked about a lot and makes sense.

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I think I've seen Sarna at Wallgreen's. I have also ordered it over the internet. How far along are you? I think I was about 30 weeks before I started to have symptoms, but I've read many stories of women who start in the first trimester. Ugh. I've also read all the scary stories about stillbirth, but almost all of them have happened when the mother was either untreated or the baby wasn't delivered by the 37 week protocol. Please keep us posted about the results when you get them on Monday!

I am 26wks, but I've been dealing with this problem through most of my pregnancy (since the latter half of the first trimester)...just now finding out why though.

 

The OB explained that the bile enzymes, since the liver is backed up, get sent to the skin.

Edited by mommaduck
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I am 26wks, but I've been dealing with this problem through most of my pregnancy (since the latter half of the first trimester)...just now finding out why though.

 

The OB explained that the bile enzymes, since the liver is backed up, get sent to the skin.

 

 

Yes, the bile acids get squished out of the liver into the bloodstream basically. Then they pool up in your hands and feet and that is where the itching is the worst. No one who hasn't felt that kind of unreachable under the skin itching can understand how bad it can be. Strange that it would show up now after 7 normal pregnancies, though. I hope the next 14 weeks go by quickly for you! (Actually you can probably count on 11. :001_smile:)

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Yes, the bile acids get squished out of the liver into the bloodstream basically. Then they pool up in your hands and feet and that is where the itching is the worst. No one who hasn't felt that kind of unreachable under the skin itching can understand how bad it can be. Strange that it would show up now after 7 normal pregnancies, though. I hope the next 14 weeks go by quickly for you! (Actually you can probably count on 11. :001_smile:)

For me it's not my hands and feet...it's my stomach, my breasts, my chest, my thighs, and my shoulders.

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Hi Momma Duck

 

I'm soooo sorry you are suffering with this. I experienced IHCP with my 5th child. The itching began between Christmas and New Year's and I had NO relief until he was born on April 11, my 2nd vbac AND 17 days past my due date!!! I was C.R.A.Z.Y. My OB monitored me very closely. (My 4th and 6th were also this late)

 

I took Enzymatic Therapy's Liver Support that has the milk thistle and dandelion and I tried a MILLION different things. I don't remember any relief. Sunshine seemed to help me cope, but it was mostly cold weather, so I didn't get much of the warmth.

 

Noone can begin to understand the itching unless they have had it.

 

I am happy to say that it did NOT recur with my 6th. :)

:grouphug:

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