Christine asked about cholestasis of pregnancy:
>
> I have permission to post from this mother.  She is 34 weeks with her
first
> baby.  She has a condition known as cholestasis (bile overflow from the
liver
> which causes severe itching).  Right now she is taking hydroxyzine
(atarax) (25
> mg) qid and diphenhydramine (50 mg) as needed, usually at bedtime.  She is
> concerned about the drugs effect on her ability to breastfeed once she
delivers.
>  Any information on long term drug use during pregnancy and possible
> ramifications on the fetus and/or breastfeeding?
>
> Also, she has been told that she might be induced early if the drugs
cannot
> keep the itching under control as it causes stress to the baby.  Her
doctor has
> not been specific on what the "stress" is or under what conditions
induction
> would be an option.  A search of several resources and a second opinion
have
> not rendering much information either.  Any one have any experience and/or
> knowledge of this condition and its effect on the fetus and ensuing
decisions to
> induce?
>


Christine,
I had this condition with all 3 of my pregnancies.  Wasn't diagnosed until
#3.  It is truly miserable.  My Mother had this as well with both of her
pregnancies (she didn't know what it was until we figured it out with me).
Since my MD with 1 and 2 didn't know about this condition there was no
suggestion that I be induced early because of the risk to the baby and I
received no symptomatic treatment.  I was induced with #'s 1 and 2 at my
insistence because of the itching (I was scratching myself to bleed)-I was
40 weeks with both.   With #3, when we finally had a diagnosis I was treated
with cholestyramine and it seemed to make it tolerable so I wasn't begging
to be induced again  (or maybe it was the miserable experience of being
induced that made the itching preferable  to being induced again-I don't
know) and my MD didn't recommend induction.  I delivered spontaneously at 40
weeks.   Had no problems with any of my baby's tolerating labor or
breastfeeding.  I took benadryl on occasion to see if it would help with the
itching but it didn't-wasn't taken regularly though.  I didn't develop
jaundice.  Also, before giving birth with #3 we checked my protime and it
was fine.

There is general information on the condition at:

http://www.britishlivertrust.org.uk/content/diseases/obstetic_cholestasis.as
p

Tell this mom she has my sympathy.

Sally Myer RN, BSN, ICCE,

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