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Pregnant. Noticed Yellowing Fingernails. Blood Test Done. Will This Have Any Affect On Baby?

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Posted on Fri, 17 Aug 2012
Question: Hi I'm 38.4 weeks pregnant I'm worried about cholestasis my feet itch - and thdn I notice my nails are yellow is that also a sighn of cholestasis - I did take a blood test but results take 48hrs and jm nervous baby will get sick by then - I'm already schedualed for a csection on July 30 but I'm nervous baby will. E sick by then
doctor
Answered by Dr. Timothy Raichle (1 hour later)
Hello, I would be happy to help you with your question.

You are correct, the labs might take longer to get back than it will take to get you delivered. There are other lab abnormalities associated with cholestasis, though. Your doctor needs to assume that this could be the case and you need to be seen and the following needs to happen:

1. You need to go ahead and have the bile salts drawn
2. You need tests of liver function drawn
3. You need to have your baby monitored ASAP to assess fetal well-being - this can be done by putting you on the monitor and also doing an ultrasound to check fluid levels. You can also have an ultrasound done that is called a "biophysical profile". This is also an excellent way to assess fetal well being.

Given how far along you are, and given the risks to the fetus of cholestasis of pregnancy, and given the inability to make the diagnosis before Monday, I think it would be reasonable to assume a worst case scenario and ask for a delivery tomorrow - this must be discussed with your doctor - this is not medical advice, just a thought process whereby you can make an informed decision with your doctor.

I hope this helps!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (1 hour later)
I will call and ask dr tommorow - in the meantime I'm just wondering if yellow nails are a symptom of cholestasis - I'm not super itchy I probably more paranoid then anything
doctor
Answered by Dr. Timothy Raichle (13 hours later)
Hello and I am sorry for the delayed response.

The yellow nails might be a sign of jaundice. This can be an indication of liver disease. If you had jaundice you would also notice yellowing of the whites of your eyes. Definitely bring this all to the attention of your doctor.

Let me know what happens!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (6 hours later)
My dr told me there's no way he's delivering me before Monday and said nothing could be done now and just to make sure I feel movement I am upset and frustrated that he did nothing to reassure me just told me I need to wait till Monday - not sure what to do I guess I will just hope for the best -
doctor
Answered by Dr. Timothy Raichle (58 minutes later)
Did he actually see you in clinic? Did he look at your nails? Was your blood pressure normal?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (40 minutes later)
No he did not even want me to come in just told me no matter what I'm not having delivery before Monday because hed have to do an amino first without my results of liver function - I am super annoyed with him
doctor
Answered by Dr. Timothy Raichle (25 minutes later)
The liver function tests should not take 48 hours. If those were drawn yesterday, they should be back by now. Are you in a small hospital? Is there a high risk service?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Timothy Raichle (13 minutes later)
I'm going to deliver in mt Sinai it's a very advanced hospital - but their policy is no births before 39 weeks without an amino - the lft test should be back today my dr closes at 1 pm on Friday I hope they will be responsible and call me if test numbers are bad - so basically the lft test alone without the bile salts test won't make them take baby without an amino - I'm super stressed and so upset at my dr to leave me with so much anxitey over the weekend - the hospital l&d doesn't take you without your drs consent so I'm up the creek - I don't have the dark urine or upper quad pain just itchy feet and yellow nails my tounge and eyes are not yellow so I'm rating I don't have cholestasis
doctor
Answered by Dr. Timothy Raichle (17 hours later)
Yes I perhaps would assume that they would call you. In the meantime, pay close attention to fetal kick counts. In any two hour window you should feel movement. I have my patients make sure they can feel ten movements in two hours. Please let me know when you are delivered and how things went!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Timothy Raichle

OBGYN

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Pregnant. Noticed Yellowing Fingernails. Blood Test Done. Will This Have Any Affect On Baby?

Hello, I would be happy to help you with your question.

You are correct, the labs might take longer to get back than it will take to get you delivered. There are other lab abnormalities associated with cholestasis, though. Your doctor needs to assume that this could be the case and you need to be seen and the following needs to happen:

1. You need to go ahead and have the bile salts drawn
2. You need tests of liver function drawn
3. You need to have your baby monitored ASAP to assess fetal well-being - this can be done by putting you on the monitor and also doing an ultrasound to check fluid levels. You can also have an ultrasound done that is called a "biophysical profile". This is also an excellent way to assess fetal well being.

Given how far along you are, and given the risks to the fetus of cholestasis of pregnancy, and given the inability to make the diagnosis before Monday, I think it would be reasonable to assume a worst case scenario and ask for a delivery tomorrow - this must be discussed with your doctor - this is not medical advice, just a thought process whereby you can make an informed decision with your doctor.

I hope this helps!