intrahepatic cholestasis of pregnancy

Question 1

clinical features

Answer 1

**in 3rd trimester
** generalized pruritic (mostly hands and legs)
no rash
**RUQP

Question 2

laboratory abnormalities

Answer 2

*increased total bile acids (>10 mol/)
* increased liver transaminase (typically < 2 times the normal ,rarely >1000 u/l)
*increased total and direct bilirubin (not always )

Question 3

obstetric risks

Answer 3

**intrauterine fetal demise
**preterm delivery
*meconium stained amniotic fluid
*neonatal respiratory distress syndrome

Question 4

management

Answer 4

*ursodeoxycholic acid
*antihistamines
*delivery at 37 weeks gestation