Imput desired about pregnancy and psc

February 7, 2008

Hi everyone. Yesterday I found out that I am about 7 weeks pregnant.

This came as a shock but I am excited. Right now I am just worried

about everything. This is my first pregnancy and I have had PSC for

about 3 years now. I am on several medications including a narcotic

pain killer. My primary care dr spoke with the High Risk OB and they

stated that I could stay on all my meds but needed to go easy on the

pain medicine. My question to everyone out there is does anyone have

advice as to what I can do to help make this a success. Anything is

welcome right now I am just plain scared.

Thanks

Sandi

February 7, 2008

Sandi,

This is so very exciting! I wish I was going through the same thing again

(my kids are 10 and 12 and I love them dearly, but nothing compares to the

excitement of finding out about them in the first place). I could say don't

worry, but you will, as any prospective mother does. All I say is go with

the flow, accept the good times (excitement) with the bad (nervousness), and

enjoy the end of your freedom!

Congratulations,

Penny T (Australia, psc 1997, listed for transplant Aug 07)

Hi everyone. Yesterday I found out that I am about 7 weeks pregnant.

This came as a shock but I am excited.

February 7, 2008

Wow. congratulations. Some might be critical that the risks are too

high, but this risk can bring a wonderful benifit.

To lower the risks, you could consider;

Working with a high risk perinataligist

Get vit D level checked to make sure over 35

Folic acid is in prenatal vitamins and is extremely important early on.

Consider working with a pain specialist to come off pain medication.

They might consider using Subutex to taper off and to prevent perinatal

withdrawl.

Best wishes

Von

February 8, 2008

What risks? I talked to my hepatologist about this just a few weeks

ago and he said that, medically speaking, there was no reason to not

get pregnant. He only mentioned that it be sooner than later because

of increased risk of infertility as the disease progresses. I'm not

currently on any meds though.

I should mention that in my previous pregnancy, pre-diagnosis, my LFTs

normalized. I've been breastfeeding for over a year now, and it's

only been during my most recent blood tests that my LFTs are beginning

to rise again. You may find that you feel better. Pregnancy does

some wierd stuff to your body! Enjoy it and congratulations!

>

> Wow. congratulations. Some might be critical that the risks are too

> high, but this risk can bring a wonderful benifit.

February 8, 2008

The risks might be related to the severity of PSC.

Below is a reference to and article by Lindor about a sucessful

pregnancy with PSC severe enough to need a bile stent after delivery.

We are not posting copyrighted material in this group, but I would be

happy to email the abstract (emailing the abstact from Medscape is

permitted) If you could find the full article, I'm sure it would

discuss the risks that they were concerned about and maybe have

reference to other articles.

Pregnancy in a patient with primary sclerosing cholangitis.

J Clin Gastroenterol. 2002; 35(4):353-5 (ISSN: 0192-0790)

Gossard AA; Lindor KD

Divison of Gastroenterology and Hepatology, Mayo Clinic and Foundation,

Rochester, Minnesota, USA.

February 9, 2008

The abstract is freely available at http://lib.bioinfo.pl/pmid:12352301

J Clin Gastroenterol. 2002 Oct ;35 (4):353-5 12352301 Pregnancy in a patient with primary sclerosing cholangitis. A Gossard , D Lindor Primary sclerosing cholangitis (PSC) is a chronic cholestatic syndrome that is characterized by fibrosing inflammatory destruction of intra- and/or extrahepatic biliary ducts. The etiology is unknown and there is no known effective treatment. The course of PSC is quite variable; however, the disease is typically slowly progressive. There is little known regarding the natural history and potential complications of pregnancy in a patient with PSC. This case report details a 36-year-old woman with PSC who became pregnant. The pregnancy was complicated by the development of dominant stricture. A healthy baby boy was delivered at 33.5 weeks. The mother required cholangiography and stent placement immediately after delivery, but her postpartum course was otherwise unremarkable.

The suspected reason for reduction of PSC symptoms during pregnancy is that the fetus' liver is doing the work of the mother's.

Arne

________________________________

From: [mailto: ] On Behalf Of jumputah

The risks might be related to the severity of PSC.

Below is a reference to and article by Lindor about a sucessful

pregnancy with PSC severe enough to need a bile stent after delivery.

We are not posting copyrighted material in this group, but I would be

happy to email the abstract (emailing the abstact from Medscape is

permitted) If you could find the full article, I'm sure it would

discuss the risks that they were concerned about and maybe have

reference to other articles.

February 9, 2008

-------

The suspected reason for reduction of PSC symptoms during pregnancy is

that the fetus' liver is doing the work of the mother's.

Arne

-------

I had no idea. I didn't realize that was possible. Oddly, my numbers

went down well before the fetus even developed a liver. I had assumed

that the supression of the immune system during pregnancy (so the body

will not reject the fetus) was the cause.

Suzanna

February 9, 2008

Sandi,

I'm sort of an expert on the psc pregnancy thing (jk of course).

I have had four children since being diagnosed. All of my children

are healthy and happy. The first two pregnancies were great. The

only issue that I had was some pain towards the end, right before the

babies " dropped " . The last two I developed pre-eclampsia with, so

they had to be born 3 weeks early. From what my GI and High Risk OB

said, the real risk to a psc patient during pregnancy is pre-

eclampsia. With the first baby I was watched very closely with the

following pregnancies, they treated me as any other patient. Congrats

on the baby!!!! Try to relax and just enjoy being pregnant. Feel

free to email me if you have any questions though.

>

> Hi everyone. Yesterday I found out that I am about 7 weeks pregnant.

> This came as a shock but I am excited. Right now I am just worried

> about everything. This is my first pregnancy and I have had PSC for

> about 3 years now. I am on several medications including a narcotic

> pain killer. My primary care dr spoke with the High Risk OB and they

> stated that I could stay on all my meds but needed to go easy on the

> pain medicine. My question to everyone out there is does anyone have

> advice as to what I can do to help make this a success. Anything is

> welcome right now I am just plain scared.

>

> Thanks

> Sandi

>

February 9, 2008

Oh and as another member mentioned, my liver enzymes also normalized.

I felt absolutely great for the most part. My GI even joked that I

should get pregnant once a year for the next 10 years.