Okay, so this will be a little on the long side as far as posts go, but I wanted to write it all out anyway. We try to keep all of our family and friends in the loop as much as we can and this seems like an easy way to do it. Also, National ICP Awareness Day was last week and as you are about to read we are very aware and so should others be. If one pregnant gal reads this and realizes her itchy hands and feet deserve a second look then I feel it was justified to write it.
So to begin.
We found out last week that the liver condition that I had during pregnancy with Liam has returned for this pregnancy. It is called ICP or Intrahepatic Cholestasis of Pregnancy and the best way I can explain it is this:
It is a liver disorder which occurs during pregnancy, usually only showing up in the third trimester or end of the second trimester. It affects the normal flow of bile- slowing it down and causing the bile acids to build up in the blood which results in the mother itching. The itching can vary in severity but usually is worse at night and shows up most often as itching on the hands and soles of the mothers feet (though it can sometimes cause the mom to itch all over).
NOTE: By itching I mean an INTENSE- want to rub sandpaper on your feet and hands- kind of itch! Some women will scratch until they draw blood that's how bad it can get. Trust me you haven't itched like this!
The risk:
ICP is associated with an increased risk of stillbirth, preterm labor, fetal distress, respiratory distress, maternal hemorrhaging and meconium passage in utero.
The best way to avoid these risks seems to always be early delivery at 36/37 weeks of pregnancy. There are some medications that help with the symptoms (mostly the itching) but do not guarantee the safety of the baby. Everything I have read point to early and intense monitoring and delivery once certain bile levels are reached in the mother.
(The best info I've found on it online comes from www.icpcare.org if you need more details.)
The basic thing you need to know is that untreated or unmonitored it can be deadly for the baby- even with proper monitoring it is a very scary reality that stillbirth is still a "greater than desired" possibility.
The day we discovered it with Liam we were induced immediately two days before hitting 36 weeks pregnant, but this go around we have caught it much sooner (30 weeks). So now we are playing the waiting game. We met with our doctor last Thursday and here is her game plan for now-
We will be monitored every Monday and Thursday by non stress tests for Ella Jane just to make sure she is doing okay via heart rate and oxygen levels. Every Monday they will do blood work to check my bile level and liver enzymes and each Thursday give us the results. (It takes that long at the lab to get the results.)
My last level read 29.1 last Monday and my OB has stated it is not dangerous for the baby until the levels hits 40.0. That said, her plan is to give me steroid shots for EJs lungs when my levels reaches mid 30s and plan to induce early. How early will depend on how fast and how high my levels go and how EJ is reacting. Right now we have no idea how fast my levels are rising (we will have a better idea on Thursday when we see how much it rose in a weeks time). She is hoping we make it to 35/36 weeks but if it hits 40.0 before then or EJ appears to be in distress at all we will have to readdress.
We are currently at 31 weeks so our hope is we can squeeze out another 3-4 weeks if not more. No matter what she will induce at 37 weeks to air on the safe side as at that point the baby is in more danger by the day but considered to be full term if I'm not mistaken. We are taking it all day by day!
In the meantime we are doing kick counts each hour or two to make sure she is still active and taking a prescription which we hope at the very least will relieve some of the itching and hopefully slow my levels down some. Also, Brian is on a dietary kick based off what he has read online that helps detoxify the liver of bile, so nasty hot teas and hot lemon water for me daily! (Someone save me and get me a Starbucks!)
Anyway, to sum it up, we are asking for prayers that EJ arrives safe and healthy whenever she comes.... And for peace for Brian and I in the stressful waiting. We know God's plan is bigger than medicine and we know no matter what he has it under control!
More updates as we learn things and get more results each week.
-Amy
