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Itching for Answers

Mom-to-be knew extreme itchiness during her pregnancy needed medical attention

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Joanne Quinones, MD
Maternal fetal medicine

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Jennifer Sicinski, 31, a mother of two from Harleysville, Pa., knew something was wrong. She was 22 weeks pregnant with her third child and had begun to experience terrible itching. It started on her legs and was becoming so severe that she had trouble sleeping.

“I started waking up with my feet burning. I would put them in an ice water bath before bed,” Sicinski says.

“I had no answers and was starting to feel I was crazy.” Sicinski searched the internet and read about intrahepatic cholestasis of pregnancy (ICP), a condition that lists extreme itchiness as a symptom.

Classic ICP

Sicinski was referred to LVPG Maternal Fetal Medicine by her OB-GYN. There Sicinski met nurse practitioner Karen Tiedeken, CRNP, who immediately recognized the cause of Sicinski’s symptoms.

“Jennifer’s bioassays were not high (for ICP), but the diagnosis can be based on symptoms alone,” Tiedeken says. “Jennifer was taking a hairbrush to the bottoms of her feet. That’s classic ICP.”

ICP is a liver disorder affecting about 1 percent of expectant mothers. Most women recover completely, but the risk for sudden fetal death is as high as 11 percent, particularly after 36 weeks’ gestation. Treatment can include prescription medication and soaking affected areas in lukewarm water. In addition, the fetus is carefully monitored until delivery.

Pregnancy care with ICP

Sicinski transferred to LVPG Maternal Fetal Medicine for care for the duration of her pregnancy. “We started monitoring Jennifer two times per week using ultrasound to check on fetal well-being,” says fellowship-trained maternal fetal medicine specialist Joanne Quinones, MD, also with LVPG Maternal Fetal Medicine. Plans were made to induce delivery at 36 to 37 weeks.

Nora Grace was born July 14, about three weeks early, but perfectly healthy.

“We take a lot of pride in providing excellent care to women with high-risk pregnancies,” says Quinones. “Every person on our team, including maternal fetal medicine specialists, nurse practitioners and our certified nurse midwife, is focused on the well-being of you and your baby or babies. We will do all we can to help you to a successful delivery.”

It’s a pride point Sicinski echoes. “We are just so thankful that we met the team at LVHN who helped me through ICP and ensured the safe delivery of our daughter,” she says.