UK OBSTETRIC CHOLESTASIS COMPENSATION CLAIMS

Obstetric Cholestasis is a liver disorder that affects approximately 1% of pregnant women and continues until delivery. The condition results from a reduced flow of bile fluids which are produced by the liver and often the only symptom that occurs is itching, particularly on the hands and feet. The itching disappears within a week or two of delivery however the condition does pose an increased risk of harm to the baby and may prove fatal unless it is recognized promptly and treated properly. It can be unbearable for the mother but the greatest risk is to the unborn baby, who will need to be delivered early, around 35th to 38th week to help prevent the possibility of stillbirth. Subsequent pregnancies for the same mother may require earlier delivery than the first baby, as obstetric cholestasis usually increases in intensity in subsequent pregnancies.

Medical research indicates that high levels of oestrogen produced during pregnancy inhibit bile flow which creates a build up of bile salts in the blood resulting in itching and occasionally jaundice. The build up of bile salts poses a danger to the unborn child which becomes greater in the latter stages of pregnancy and can result in stillbirth. The latest research suggests that it is linked to increased oestrogen levels, including those carrying twins, who have an increased incidence of the disease and that it is often a hereditary condition and can skip several generations. Any pregnant woman who believes that she is itching more than normal should seek professional help which usually means having a doctor take a blood sample for evaluation of liver function. If liver function is abnormal and after eliminating all other possible diseases and disorders a diagnosis may be made. This condition is relatively rare and many midwives, doctors and other medical staff are not knowledgeable about the proper procedures for handling this disease.

Symptoms of obstetric cholestasis may be difficult to diagnose until the patient is very ill, however itching usually starts on the soles of the feet and the palms, extending to the rest of the body. It can involve the face, ears, mouth and head and is usually worst during the night, leading to sleep deprivation, exhaustion and physical and mental fatigue of the mother. Mild jaundice affects about 20% of patients and some babies are born jaundiced. Nausea and vomiting can also be present throughout pregnancy and 50% of mothers get urinary tract infections. Mothers may suffer from malabsorption of vitamins, worsening maternal nutrition and there is about a 20% risk of postpartum haemorrhage which may be caused by inadequate absorption of vitamin K which is needed for the blood to clot.

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