ADVOCATING FOR BILE ACID TESTING

The diagnostic lab for ICP is the total bile acid test.  

This is performed via blood draw of the expecting mother.

The level of bile acids is a critical part of treatment for ICP as it may indicate the necessity of an early delivery.  Many times bile acid levels rise after symptoms of ICP have already been present for some time.  For this reason, it is essential to continue to check bile acid levels as long as symptoms continue.  The continual checking of bile acid levels is also important because bile acid levels can spike very quickly.  This spike can be very dangerous to the unborn baby; therefore, the lab results need a quick turnaround. 

THE PROBLEM:

Currently, there is only one lab in South Carolina that runs the total bile acid lab in-house.  Other facilities use a send-out lab to another state, therefore results can take several days.  Days is entirely too long!

Why are total bile acid tests a send-out?

The total bile acid test is likely a send-out because the common method presently used for testing requires expensive lab equipment that is not available in most labs.  It also is a send-out due to low demand for the test.  The demand would be much higher (and should be much higher) if all expecting moms who were experiencing symptoms would be tested and would continue to be tested as long as their symptoms continue.  

THE ANSWER:

There is an alternative method for testing the total bile acids that requires lab equipment that most medium-to large-size hospitals already own.  This method also gives fast and efficient results within one hour.  This method is being used in almost every hospital in the United Kingdom, and, therefore, their expecting moms get results right away.  This allows the treating physician to have the information needed for a safely-timed delivery.  Yale University has also recently started using this method, as they recognize that it is a vital part of treatment.

Judd’s Legacy is happy to announce that in-house bile acid labs are officially being performed in the state of South Carolina. Testing at PRISMA Health in Greenville began on November 1, 2021 and has a 3 hour test result turn around.

“I started itching around 30 weeks, went for initial bloodwork around 33, and was diagnosed with ICP (after some back and forth with my OB even with a bile acid level of 20). Liver functions were normal. Maternal Fetal Medicine confirmed my diagnosis (somewhat reluctantly) and deemed it NOT necessary to get repeat bloodwork since I’d be on the suggested medication. A week later, I asked for that repeat bloodwork because I couldn’t just trust that my levels were fine with no evidence to back up the doctor’s claim that the meds would help. At 34.6 weeks (the day after I got bloodwork), I was told to go to L&D because my liver functions had skyrocketed (this was less than two weeks after my initial bloodwork). My levels continued to climb by the hour, and I was diagnosed with Atypical Severe Preeclampsia in addition to ICP. I was induced the next day at 35 weeks exactly. It wasn’t until after my son was born that my BA levels came back at a whopping 240. Once again, this is less than TWO weeks since having levels of 20, taking medication three times a day, and a recommendation that repeat bloodwork wasn’t necessary. Frequent bile acid tests are a MUST, and the turnaround time needs to be quicker. As much as I didn’t want the other complications, I’m almost grateful for them because those are what ultimately led to my induction. Had I waited for those BA results to come back, my beautiful baby boy might not be with me today. 

 

Thank you to Judd’s Legacy and especially Judd’s mama for spreading awareness and for saving so many beautiful ‘itchy’ babies.”

                                                                                               ~ Kristy ~