Liver problems

Question 1

What is obstetric cholestasis?

Answer 1

Cholestasis that develops in the third trimester and usually resolves after birth, stoppage or reduction in bile flow

Question 2

How does obstetric cholestasis present?

Answer 2

Generalised itching worse on hands and feet, no rash, RUQ pain, malaise, steatorrhea

Question 3

What would you see on LFTs

in OC

Answer 3

Raised transaminases (ALT/AST), raised bile salts

Question 4

What does OC increase risk of in the mother?

Answer 4

PPH due to vit K deficiency

Question 5

What does OC increase risk of in baby?

Answer 5

?Preterm labour, still birth, meconium

Question 6

how is OC treated

Answer 6

Prophylactic vit K- antihistamines for itch, ursodeoxycholic acid- itch

Question 7

How is OC monitored?

Answer 7

Weekly LFTs and clotting screen- 2 wk USS and CTG

Question 8

When should mums w OC deliver?

Answer 8

37-38wks

Question 9

What is DD ofOC?

Answer 9

Gallstones, Acute viral hepatitis, primary biliary cirrhosis