Obstetric Choleostasis Flashcards
1
Q
Explain the pathophysiology behind OC
A
- affects pregnant women from 28/40 when oestrogen levels are at highest
- linked to genetic disposition for increased sensitivity to oestrogen resulting in metabolic defect in hapetocytes in liver
- bile is produced and stored in liver and is involved in breakdown and excretion of fats in liver
- pregnancy disrupts the flow of bile
- bike salts involved in emulsification of large fat molecules into smaller droplets for digestion start to accumalate under skin
- increase in levels of bile salts causes histamine to be produced causing pruritis
- disruption in circulation impedes absobance of vitamins and minerals effecting coagulation
2
Q
What are the signs and symptoms of OC? (8mks)
A
- extreme pruritis in hands and feet
- UTIs
- Hyperbilirubinaemia- jaundice
- nutritional impairment and malabsorption
- pale stools
- insomnia from itching
- anaemia
- malaise
3
Q
What are the complications of OC? (8mks)
A
- increased morbidity and perinatal mortality
- preterm delivery from stimulation of prostaglandins by bile acids
- vasoconstriction of cord by bike acids causing hypoxia
- increased fetal colonic mortality caused by release of meconium causing acute umbilical vein to construct
- liver failure/impairment
- PPH
- Abnormal CTG
- IUD
4
Q
What are the risk factors for OC? (4mks)
A
- previous history of OC
- multiple pregnancy
- genetic traits in some ethnicities
- environmental seasonal and dietary requirements
5
Q
Carrie comes to you at 30/40 with itching to her hands and feet and a HX of OC in her previous pregnancy explain your management plan
A
😊
