When is induction of labour recommended for obstetric cholestasis?

Obstetric cholestasis is a pregnancy-related liver condition that often causes itching, especially on the palms or soles, and can alter bile-acid blood tests. The timing of birth is not based on itching alone. Your team considers the highest bile-acid result, whether results are rising, liver function, other pregnancy complications, fetal movements, and gestational age. Medication may ease symptoms, but it does not replace planned monitoring and a birth discussion.

Attend repeat blood tests and antenatal checks, and report changes in itching or fetal movement. Ask how often bile acids and liver tests will be repeated, what result would change the plan, and whether induction or caesarean birth is more appropriate. Follow advice about medicines and skin comfort, and keep your maternity team informed of any new symptoms.

Contact your maternity unit urgently for reduced fetal movements, vaginal bleeding, leaking fluid, regular contractions, or severe abdominal pain. Seek immediate assessment for a severe headache, visual disturbance, or feeling very unwell. New or rapidly worsening itching should also be reported so testing can be arranged or reviewed.

What are my latest bile-acid and liver-test results? How are they affecting the proposed birth timing? What monitoring will continue before delivery? What should I do if itching or movements change?