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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Hyperemesis Gravidarum, Nausea, Vomiting, Itching, Painful Tummy, Loose Stools. Bile Acids Checked. Obstetric Cholestasis?

Hi. I am a 27 yr. old woman. I am 35.2 days pregnant with my third baby. A little over 2 weeks ago I began itching on my legs. Over the following days it spread to my whole body, and became much more prominent at night, after dinner. I have been suffering from severe Hyperemesis Gravidarum for most of this pregnancy. At one point I had a PICC line placed for TPN. The nausea and vomitting stopped around 25 weeks, but since this itching started I have become nauseous again, and have vomitted a few times. The nausea is worse after meals, sometimes itching occurs after meals too. I have pain on top of my stomach after bowel movements, and have been having intermittent loose stools when normally I have been backed up for most of the pregnancy. I had my bile acids checked last week (non-fasting) and am told they are within normal limits with a ratio of 1:1. Since the itching is still persisting and I am increasingly nauseated I convinced my OB to re-draw bile acids to check if my levels are rising. Should I be taking other measures? I am concerned that I do have OC even though my labs are not elevated yet.
Mon, 22 Apr 2013
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OBGYN 's  Response
Itching or prurigo with pregnancy is common even if your bile tests are normal, I would suggest that you have either local or oral medications that help itching. As far as emesis, it has no rule for the exact course or the time that it is going to stop, again antiemetic medication could help. Being pregnant does not mean that you have to suffer
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Severe Hyperemesis Gravidarum, Nausea, Vomiting, Itching, Painful Tummy, Loose Stools. Bile Acids Checked. Obstetric Cholestasis?

Itching or prurigo with pregnancy is common even if your bile tests are normal, I would suggest that you have either local or oral medications that help itching. As far as emesis, it has no rule for the exact course or the time that it is going to stop, again antiemetic medication could help. Being pregnant does not mean that you have to suffer