Obstetric Cholestasis Solicitors - Medical Negligence Compensation Claim


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Undiagnosed or late diagnosed obstetric cholestasis places an unborn child in grave danger. There is a real possibility of death within the uterus of the unborn child and subsequent stillbirth. If you have suffered the consequence of errant diagnosis it may well have been as a result of a clinical error. Where this occurs due to medical negligence our solicitors can help you to obtain compensation from the doctor or health authority. A medical negligence solicitor will take a detailed statement after consideration of your medical records and will obtain medical opinions from experienced clinicians to establish whether or not death was due to negligence. If you would like free advice from a specialist medical negligence solicitor without further obligation just use the helpline or contact our offices by email.

Obstetric cholestasis is also known as cholestasis of pregnancy or intrahepatic cholestasis of pregnancy. It is a reasonably rare complication of pregnancy that involves the loss of bile from the liver. Bile is a clear yellow or orange liquid produced by the liver and stored in the gallbladder. It flows into the small intestine via the bile ducts and is used when needed to aid digestion.

Definition

Cholestastasis is the stoppage or suppression of the flow of bile. Obstetric Cholestastasis is a liver disorder that affects a small number of pregnant mothers. It generally occurs after 20 weeks gestation and is thought to be caused by the oestrogen hormone interacting with the liver. This interaction inhibits flow of bile into the bowel. Bile salts build up and cause toxins to enter the blood stream.

Symptoms

Symptoms can be varied in different women, but there are some standard symptoms by which obstetric cholestasis can be positively identified. These include :

  • Severe itching is the most common symptom and causes a great deal of discomfort to the mother. The itching can be particularly persistent on the skin of the hands and feet, but it can spread over the whole body, and it is often more intense at night.
  • Tiredness due to lack of sleep caused by the skin discomfort can lead to depression.
  • Lack of appetite due to feeling nauseous. Although this is a common problem in many pregnancies, it is another symptom used to diagnose obstetric cholestasis.
  • Jaundice is yellowing of the skin and the whites of the eyes, and is a major pointer towards this condition.
  • Dark coloured urine - The obstruction of bile flow may cause bile to enter the urine, making it dark in colour.
  • Pale stools caused by a decrease of bile in the gut

Diagnosis

Obstetric cholestasis is found in approximately 1 in 100 pregnant women. It is most common in women who are carrying more than one baby, as well as those whose mother, sister(s) or other genetically close relatives have suffered the condition. These informational factors are the first line of questioning and consideration in the investigation of a diagnosis by an obstetrician.

After the genetic links have been explored, the next level of diagnosis is by the process of elimination. The presence of all, or most of the common symptoms listed above, is established or discounted and, if all are found, it is almost certain that there is a positive diagnosis of obstetric cholestasis. Further, more specific, blood tests determining the status of liver function can be performed to conclusively identify the condition.

The reason it is so important for a correct diagnosis to be made as soon as possible, is due to concerns for the safety of the baby. Unfortunately, a stillbirth is a sad but common outcome if an early diagnosis is not reached. Even if obstetric cholestasis is only suspected, the condition is so serious for the baby that close monitoring is needed throughout the pregnancy. Usually the baby is delivered at between 35 and 38 weeks to prevent stillbirth or future damage.

Treatment

The only cure for obstetric cholestasis is the delivery of the baby; therefore, the sole treatment protocol available before the due date is to relieve the most severe and debilitating symptoms.

The worst of the intense itching is often relieved by naturally cooling the skin with cold water and cool air and medicated steroid creams, although care must be taken with the use of these creams because the main interest is the welfare of the baby.

An added complication with this condition is that it is likely to occur in subsequent pregnancies with ever more pronounced symptoms.


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