Cholestasis affects a few percent of expectant mothers. It usually appears in the third trimester of pregnancy and is characterized by severe itching of the skin, jaundice and enlarged liver. The story of Magda from Gniezno, suffering from pregnancy cholestasis, shows that quick diagnosis and good care will avoid complications.

Pregnancy cholestasishappened to her only in her second pregnancy. During the first months of her second pregnancy, Magdalena (mother of 9.5-year-old Kacper and 3-month-old Kuba) felt great. She swam, cared about her diet and commuted to work every day.

Gestational cholestasis usually occurs in the third trimester

- Around the beginning of the third trimester, I started to feel itchy all over my body from time to time. I thought it was an allergy to chlorine in the pool which I used to go to quite regularly. When I went to the doctor in late September, I casually mentioned the itching to him. The doctor was very concerned about this and ordered to immediately perform tests for the levels of enzymes: ALAT, ASPAT and bilirubin. He suspected that it wasintrahepatic pregnancy cholestasis- a liver disease that occurs only in pregnant women, is dangerous for the fetus and manifested by itchy skin. I did not delay my research. When I returned to the doctor with the results, he was terrified. The level of ASPAT was 780 IU (with the norm of 30), bilirubin 3.5 mg / dl (with the norm of up to 1), and the level of ALAT was exceeded several dozen times! He immediately referred me to the hospital. He also recommended drugs: Vasosan and Ursofalk, which were to lower the level of enzymes. The itching of the skin was really persistent.

According to an expertAnna Stanisławska, gynecologist, Platinium-Med in Warsaw, www.platiniummed.pl

What is this disease?

Intrahepatic cholestasis in pregnancy is an unexplained disease characteristic of the second half of pregnancy. It affects less than 2 percent. pregnant. The main symptom is itching of the skin, especially of the hands and feet, increasing at night. It may be accompanied by jaundice. Among the laboratory tests, apart from the elevation of transaminases (AST, ALT), alkaline phosphatase (ALP) and bilirubin, there is also a characteristic increase in the serum concentration of bile acids. They can cause fetal hypoxia and premature delivery. Ursodeoxycholic acid is mainly used in the treatment of cholestasis, less frequentlycholestyramine (with vitamin K and D3 supplementation) or dexamethasone. An easily digestible diet is important. The disease is usually mild and its symptoms and indicators normalize during the 6 weeks of puerperium.

Cholestasis during pregnancy must be under constant medical supervision

After just a few days in the hospital, my results improved a lot. I was very happy that my body responded so well to the treatment. However, because I missed my older son so much, I managed to go home for a few days. I was in touch with the doctor all the time and, with the slightest fear, I was to go to the hospital immediately. I was aware that complications sometimes arise with cholestasis, incl. jaundice, and then you usually have to give birth earlier. The doctor clearly warned me that if the symptoms were severe or the test results worsened, then I have to take into account an earlier delivery. I wanted to wait until the second half of October, because it was almost on the date that I had for the beginning of November. Meanwhile, there was still a month until delivery, and I returned to the hospital again for a detailed examination. The results were good. Despite this, three times a day I had a CTG test that monitored the baby's heartbeat. From the moment cholestasis was discovered, I had to follow a diet all the time. It was a typically easily digestible diet so as not to burden the diseased liver. It was dominated by boiled vegetables, lean, cooked meat, compotes. I was to avoid anything that is greasy or fried, and replace sweets with dried fruit or delicate biscuits. I could also eat eggs, but preferably boiled, not fried, and fish. I drank a lot of herbal teas, incl. nettle, which supports the work of the liver and purifies the blood. Lemon balm and all fruit teas also served me well.

Pregnancy cholestasis may be an indication for Caesarean section

In mid-October I fainted for a while. It turned out that the baby's heart rate was very weak. At first the doctors wanted to do a caesarean section, but my condition quickly improved. It was probably thanks to the glucose drip that gave me strength. Soon I had an ultrasound and I saw that the baby was moving. I breathed a sigh of relief. I was glad that this situation happened to me in the hospital, because if I was at home, I don't know how it would end.

It's been ten days. Now I was in the hospital all the time as labor could begin at any moment. I spent this period mainly reading and thinking about the child. At the end of October, a CTG test showed that the baby's heartbeat was weak. Doctors started preparing me for caesarean section again, but after some time everythingit returned to normal: CTG results stabilized, I returned to the ward again.

From then on, however, I was anxious because October was ending and the due date was approaching. Actually, I was prepared for the fact that it could be any moment… A few days later it finally started. My amniotic fluid broke and my dilation began to progress rather quickly. This is good, because there were chances for a natural childbirth, just like with the first son. I was given a Dolargan painkiller which helped me through the contraction phase. I was a bit more tired than the first childbirth, but it was worth it. I gave birth to a he althy son, Kubuś. He was even bigger than Kacper - by over half a kilo. When he was born, he weighed 3,100 grams and measured 55 centimeters. I am glad that despite the disease it went without any complications. And a few days after giving birth, I was able to forget about cholestasis.

monthly "M jak mama"

Category:

Pregnancy