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On April 5, 2018, Jamie Wojtysiak, 32, of Villa Park, was admitted to Elmhurst Hospital a month before her due date. She had delivered her first son, Joey, at the hospital two years prior, on Feb. 13, 2016. But this pregnancy had taken a slightly different path.
Wojtysiak had developed obstetric cholestasis, also called intrahepatic cholestasis of pregnancy (ICP), a liver disease that occurs in 1-2 pregnancies per 1,000 in the U.S. The condition is marked by a buildup of bile acids in the blood, usually in the last trimester.
The most common symptom of obstetric cholestasis is intense itching, particularly on the hands and feet (although some women feel itchy everywhere), and often at night. Other symptoms may include dark urine, pale stools, abdominal pain, loss of appetite and jaundice.
Throughout her pregnancy, Wojtysiak had been receiving monthly calls from a nurse, a benefit provided by her company, Comcast, where she works as an analyst. When she noticed mild itching in her third trimester, Wojtysiak didn’t think much of it since itchy skin is pretty much a given during winters in Illinois. But she mentioned it to the nurse anyway during her check-in call.
The nurse told her to let her doctor know, which Wojtysiak did at her next appointment with William Fitzmaurice, M.D., an independent obstetrician and gynecologist on the medical staff of Elmhurst Hospital. With that, she was immediately tested for cholestasis. The first test came back negative, but two weeks later she was tested again and it was positive.
“After the diagnosis, everything went into hyperdrive,” says Wojtysiak. She needed to have biophysical profiles twice a week, along with weekly blood draws to monitor her bile acid levels and liver function.
She also needed to take a medication to keep the bile acid levels low, as elevated levels could be harmful for the baby. Wojtysiak was scheduled to be induced a month early to avoid serious complications.
Going to the hospital that day, Wojtysiak and her husband Bill, 33, an automotive technician, were very anxious about what was going to happen. From the beginning, she says, the team caring for her kept them informed and provided encouragement and reassurance.
“Every single person that helped take care of us from the time I was admitted until the time I was discharged was absolutely fantastic,” says Wojtysiak. “But there was one nurse that stood out.”
Labor and delivery nurse Marjorie Rizzo, RN, had just started her shift on the evening of April 5. Rizzo, who’s been with Elmhurst Hospital for six years, works overnights from 7 p.m. to 7 a.m.
Marjorie Rizzo, RN
“The delivery wing had been extremely busy that weekend — I think I remember hearing there were 17 babies born. As busy was they were, Marjorie made us feel as though we were her only patients. She was so attentive to us,” says Wojtysiak.
Says Rizzo, “One of my favorite things about my job is getting to know the patients. It’s easy to go through the motions. As nurses, we are there to get a job done — we need to keep both mom and baby safe. But it’s also fun to learn about each patient and to personalize their experience.”
Wojtysiak had also learned that her baby was in a breach presentation, so a c-section was a possibility if he couldn’t be flipped. Fortunately, Brian Sklar, M.D., an independent obstetrician and gynecologist on the medical staff of Elmhurst Hospital, was able to successfully flip him, and the induction started a few hours later.
“When you’re being induced it’s scary. I remember how stressful that time was for Jamie. Her baby was calling the shots, and I was trying to keep them both safe and make her as comfortable as possible. I talked Jaime through the process and reassured her that I was there for her,” says Rizzo.
Going into delivery, Wojtysiak says she and her husband were extremely nervous. The cholestasis and the early delivery already had them worried. But then, after her epidural, Wojtysiak’s blood pressure began dropping as well as her baby’s heart rate.
“Marjorie rushed in several times to reposition me and, at one point, I needed oxygen for the baby. She was the epitome of calm, cool and collected. After placing the oxygen on me and getting me to into a safe position, I believe she sensed my fear because I was on the verge of tears.”
“That’s when Marjorie placed her hand on my arm and looked me right in the eye and said, ‘Don’t worry, I’ve got you and the baby. I’m watching and I won’t let anything happen.’ That right there allowed me to relax and I truly felt safe. Not to sound corny, but that statement was probably the best thing I could have heard,” Wojtysiak says.
“It’s such a monumental experience for families that they are never going to forget, and I get to be with them for it. I try to figure out what I can do to make their experience more special,” says Rizzo. She adds, “Every night is different — every few minutes is different. Patients feel every emotion. It’s never a dull moment, that’s for sure."
At 12:38 a.m. on April 6, 2018, Wojtysiak delivered a baby boy, Matthew, 6 pounds, 7 ounces and 19.5 inches long. Although he came a month early, Matthew was “as healthy as a horse”— so good, she says, that he didn’t even need to go to the Special Care Nursery. The family was able to go home two days later.
Today, Wojtysiak says the family of four is doing “absolutely wonderful,” with Matthew now almost 7 months old and Joey a little over 2. Of her experience at Edward-Elmhurst, Wojtysiak says, “I’m so thankful for Marjorie and the whole delivery team at Elmhurst. You all truly have an amazing staff.”
Wojtysiak also credits her delivery doctor Caroline Casey, M.D., an independent obstetrician and gynecologist on the medical staff of Elmhurst Hospital, for her care. “From the time of my diagnosis to when I delivered, all of my doctors were all so wonderful and helpful,” she says.
Cholestasis that occurs during pregnancy can run in families. Women with previous liver damage or those carrying multiples are at higher risk of developing the condition. While women with obstetric cholestasis need to be monitored closely, the condition usually goes away after delivery.
Learn more about pregnancy and baby services at Edward-Elmhurst Health.
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