For the first 20 weeks of my most recent pregnancy, I was fairly asymptomatic and felt well. Unfortunately that all changed just over half-way through the pregnancy when I was hit with an itch. An itch that began innocently enough on my legs, and quickly became a much bigger problem.
When I first began itching I attributed it to my skin. After trying the skin care products I had in my home to exfoliate and moisturize, I went out and bought medicated creams - but they did not work. So, I tried Benedryl - that didn't phase it either. Small cuts were beginning to appear on my skin from the scratching. It was not as simple as "don't itch" - it was intense and impossible to ignore. The itch took over most of my body - from the bottoms of my feet to the palms of my hands. I simply could not stop itching.
Luckily, a friend recommended googling "ICP" and contacting the OBGYN. Had she not made that recommendation, I don't know that I would have mentioned the itching to my doctor as quickly as I had, since it did not seem like a pregnancy-related concern. I prefer not to think about what could have happened in that instance. As soon as I began to read about ICP, I "knew" that was the condition I was facing, and I worried that people would think I was crazy for diagnosing myself through google. Luckily, my doctor took my concern seriously, immediately ordering the necessary blood work.
It took a few days for the results to come back and I will never forget receiving the phone call that seemed to turn my pregnancy experience upside down. This was my 4th child and we expected to just coast through the pregnancy, having done it 3 times before. But that was no longer the case. Words like "induction," "premature," and "fetal demise" were terrifying to hear. Upon receiving the diagnosing results, the doctor immediately prescribed the necessary medications and increased monitoring required to effectively treat the condition. I went from a "normal" doctors visit schedule to having 3-4 appointments per week between the non-stress tests, ultrasounds, bloodwork, OBGYN appointments and appointments with a specialist. It was a huge added stress, as I still had my other children to care for, along with a new concern for my health and the safety of my unborn daughter.
Intrahepatic Cholestasis of Pregnancy (ICP, or simply "Cholestasis"), is a serious condition that effects the liver of the expectant mother, causing bile to seep into the bloodstream. This is what causes the extreme itching, and also poses a danger to the baby. ICP causes the pre-mature aging of the placenta, requiring pre-term induction. Without pre-term induction the placenta can stop working effectively, which can lead to fetal demise and still born babies. Luckily, with medication, monitoring, and induction, the odds of a healthy baby are comparable to any other healthy pregnancy - but that does not releive the fear and stress that the expectant mother experiences. Furthermore, there is little relief for the itching, which makes the remainder of the pregnancy incredibly uncomfortable, in addition to scary.
I was induced late in my 36th week of pregnancy. Thankfully my "little itch" was born healthy. We had some minor concerns immediately after birth, but everything worked itself out over her first few hours. I credit the amazing medical team affiliated with Unity Hospital, as well as the support from my friends and family. My itch has been alleviated, but scars remain on my skin from the terrible itching, reminding me constantly of the battle we won.
June 10th is ICP Awareness Day, and coincidentally it was also my due date! This June 10th however, I hold my 3 week old "late pre-term" baby, while I hope to spread some awareness about ICP and my experiences in the hopes that I may help another mom identify the itch, and fight it.
To read more about Intrahepatic Cholestasis of Pregnancy, visit http://www.icpcare.org/
Also, please advocate for yourself. If you have doubts or concerns about how a doctor is handling a concern or diagnosis do NOT be afraid to seek a second opinion and/or stand up for yourself. You know your body best and you know if something does not seem right. The ICP care website linked above includes materials you can use to help you advocate for yourself if you believe you may have ICP. This is a condition that is not thoroughly understood by many doctors, and often times a specialist doctor must be consulted to ensure treatment is appropriate.
