Monday Motivation // Maternity Monday 34 weeks pregnant

It’s been a while since I’ve updated or posted! I’ve been underwhelmed with lack of motivation while also coping with a busy schedule between multiple appointments, kid activities, birthdays, and so forth. Currently, we are 34 weeks (and 3 days) pregnant and have been unsure of whether or not we will be induced in less than 3 weeks for about a month now.

February 16th, after my bile acids had reached 16, diagnosing me with Intrahepatic Cholestasis of Pregnancy, my bile acids were redrawn and shown as 2.5, which is within the normal range. This blood result was drawn before I started ursodiol to lower the bile acid levels.

Treatment for ICP/Intrahepatic Cholestasis of Pregnancy changes from provider to provider as the condition is relatively rare, but the main treatment involves ursodiol medication, bi-weekly non-stress tests (NSTs), weekly biophysical ultrasounds, induction of labor between 36 and 38 weeks of pregnancy, and monitoring of bile acid levels. As of February 14th, my treatment plan consisted of ursodiol, twice-weekly NSTs, induction at 37 weeks, and because I pushed for it, bile acid testing every four weeks. I really would have preferred weekly… Which means that I am not due to have my levels taken again until this Thursday; 4 weeks after my levels were normal. Unfortunately, I am set to meet with my consulting doctors on Wednesday where they will look at my levels from a month ago and likely adapt my treatment plan based on serum levels that are four weeks old.

I wanted to avoid induction if at all possible as I’d rather baby come when he or she is ready, however, with cholestasis, it is possible that my body is toxic for the baby and after 37 weeks, it is in the best interest for baby to be earthside. Since my levels dropped to the normal range (something no one I’ve interacted with thus far has witnessed with this condition), I am anticipating that they will either push the induction or they will cancel it altogether… Meanwhile, my bile acids are doing who-knows-what.

We have to send the blood samples to the testing lab on the mainland in frozen form. Once at the lab, they will be tested in batches, which means that the samples can take between 4 and 10 days to return. It is likely that I won’t know what my bile acids are until the day of the potential induction!

It is worth noting that anything about 40 for bile acids can be detrimental to the baby–respiratory issues, intrauterine demise, meconium staining of the amniotic fluid, and so forth.

Trying to relax about it. I have mild symptoms: slight burning sensation in my feet with mild itching. When the ICP first came on, I was up until 6 or so in the morning scratching, patting, slathering with cream, applying ice packs, etc., to my feet to get the itching to be subtle enough to sleep through it. I tried Benadryl on the advice of my midwives and consulting OBGYN, but all it did was make me incredibly exhausted and drowsy while I scratched away!

Nausea is still very active in the morning and heart burn is painful at almost any hour of the day. My symphysis pubis dysfunction was kept at bay for a few weeks there with careful movement and physiotherapy. Last week, it started getting bad again, likely because of how baby is situated. It is hard to move from any horizontal position and being upright becomes painful relatively quickly! I’m looking forward to being a functional human being again in due time… Anytime between 3 weeks and 8 weeks lol -_-

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