Intrahepatic Cholestasis of Pregnancy (ICP)……..Wait, what?

Meet Patty….

I was over the moon excited to find out that my husband and I were expecting our first child. I was one of those women who “knew” they were pregnant immediately, but it took 15 days for a test to finally come up positive. Finally on Valentine’s Day of 2016, I ran out of the bathroom, happy tears streaming down my face, waving the just-taken test in hand, yelling “I KNEW IT!!!”

My first trimester wasn’t too bad. I was nauseous and had food and scent aversions, but I’m pretty proud to say I didn’t puke once. By the end of my first trimester, I was feeling pretty itchy, but my friends assured me that it was normal stretching. I was applying lotion like crazy to my nipples, my arms, legs, and feet. My biceps in particular were crazy itchy. One of my friends told me to look into Cholestasis. I mentioned it to my doctor, but he also reassured me that itching was normal.
 
The itch continued to get worse. I could no longer sit on my couch at home. Every night, I would eat dinner and watch tv while balancing on a yoga ball, trying not to scratch so much that I bled. The itching was so much worse at night, but I had no rash or other symptoms. My husband realized this just couldn’t be normal. His query again pointed us to Cholestasis. We brought it up at my 20 week appointment, which was at a perinatal specialist’s office (normal protocol for all 20 week appointments at my OB’s practice). The doctor’s mouth set in a grim line as my husband described the intensity of my itching, which worsened at night. “Sure sounds like Cholestasis” he concurred and ordered a blood test.
 
The results came back about a week later. It was confirmed. I had ICP. He told me he was putting me on the medication Ursodiol and that I would deliver at 36 weeks. I was in shock; that was a full month early! Would my baby be ok? Would she need to stay in the NICU? Would we need preemie clothes? I tried not to cry as I picked up my prescription. My pharmacist saw the worry in my face. I poured my heart out to her. She told me how she went into labor on her own at 36 weeks (at work!) and went to the same hospital I was going to deliver at, 40 minutes away. Her baby girl was tiny, but didn’t need any NICU time and was currently doing well. It was such a weight off my chest.
 
Throughout the remainder of my pregnancy, the itch continued, though the Ursodiol took the edge off. It was impossible to sleep at night. I ripped holes in our sheets from kicking, tossing, and turning. I had to take Benadryl to sleep, though it didn’t help with the itching at all. My showers had to be cool. I was often totally covered in lotion and fell asleep on ice packs. During the last month, I slept sitting propped up because it caused so much heartburn.
 
ICP required constant monitoring. During my final month of pregnancy, I had 3 appointments a week. That was a load of fun because I was still working at that point! Well-intentioned people would say things like “Well, at least you get to meet her a month early”, “You get out of the final month, that’s the worst!” and “At least you know when your baby is coming!” I would hate it! The reason for constant monitoring and early delivery was basically that my body was toxic to my baby and could KILL her at any point, particularly after 36 weeks. I wasn’t getting out of anything!
 
Thankfully I found great support from http://www.icpcare.org/ and their associated ICP Care/ Itchy Moms group on Facebook. There were tons of moms in the same boat as me. I was shocked to find out that there is no cure for ICP, other than early delivery, though Ursodiol can help lower your bile acids. I also found out that many doctors aren’t at all knowledgeable about ICP and that you need to arm yourself with as much knowledge as possible and advocate for your baby’s life! My baby and I are among the lucky ones that my OB and perinatal specialist were in concurrence of our care.
 
I’m so happy to say that our story has a happy ending. My daughter was born at exactly 36 weeks on September 27, 2016, the day after my birthday. She was 5 lbs, 10 oz and required no NICU time. She is now a happy and healthy 6 month old, and will always be the greatest birthday present I could ever receive.
 
 

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