It’s hard to believe it, but 9 months ago, I gave birth to my second baby. Perfectly healthy, 7 pound 1 ounce, sweet little cub. But the 9 months before that…wow.
I’ve touched on ICP but I haven’t really gone into too much because it’s not the easiest thing to talk about. Going on and on about all the ways your child could have died before he was even born is, well, hard.
ICP, or intrahepatic cholestasis of pregnancy, is a liver disorder that causes a buildup of bile acids in the blood. The bile is usually carried out and into the bile ducts, but in ICP, the cells responsible for this transportation don’t do their job. This presents quite a few significant risks to mother and baby. Fetal distress, meconium passage, pre term labor, RDS (respiratory distress syndrome), breathing complications in the baby, maternal hemorrhage, and stillbirth. Doesn’t sound so great, does it? Which is why it’s so mind boggling that so few doctors know of this or how to properly treat.
Proper (current) protocol for ICP, which is detected with a total bile acid level of 10 or above, is to immediately start a medication called Ursodeoxycholic Acid, more commonly known as urso. It’s a naturally occurring substance in the body that reduces bile acids. Continuous monitoring of the bile acid levels is also crucial to ensure they aren’t going above the severe level (40). NST (non stress testing) is also ideal to make sure the baby is still well and not in distress. The only known “cure” for ICP is delivery. Ideal delivery for ICP is in week 37 (or even earlier if the levels are rising and not controlled by urso).
The symptoms of ICP are what usually trigger the initial blood test for the bile acids. The most notable of these is the itching. Not normal pregnancy itching. This is an itch straight from hell. It’s like fire ants are crawling just under your skin, but no amount of scratching, lotions or creams, medications, or prayers can make it stop. I spent many nights on the couch sobbing hysterically from the sleep deprivation and the itching, bleeding all over my legs from scratching. Itching doesn’t sound like a big deal, but this isn’t itching. This is something that can easily lead to suicidal thoughts. The itch is not associated with a rash like PUPPS, which is what so many doctors will claim. And that may be one of the reasons the In Memory list of our little itchy group is so long. Whenever I’m having a rough day with the kids and just can’t take it anymore, I remember the babies on that list. Logan could have easily been added to it. But, I guess for once, my loud mouth and stubborn attitude actually paid off.
I know we all want to feel safe and trust our doctors. And there’s no reason to believe they don’t know what they’re doing or that they’re all wrong. But if you feel there’s something not right, there’s more going on, but your doctor won’t pursue it, there’s nothing wrong with raising your concerns or even finding a provider who will listen. Even if you’re 35 weeks pregnant. Fight the Itch. Save a Life.