obstetric cholestasis Flashcards
1
Q
what
A
reduced outflow of bile acids from liver
2
Q
when does it usually develop
A
> 28wks
3
Q
assoc w increased risk of
A
stillbirth
4
Q
features
A
pruritus fatigue dark urine pale, greasy stools jaundice NO rash
5
Q
if rash present
A
it’s not obstetric cholestasis
alt diagnosis
- polymorphic eruption of pregnancy
- pempphigoid gestationis
6
Q
Ix
A
liver function tests
bile acids
7
Q
Ix results
A
abnormal LFTs - ALT, AST, GGT
raised bile acid
8
Q
ALP
A
normal for it to be high in pregnancy - it is produced by placenta
raised ALP w/o any other abnormal LFTs is not liver pathology
9
Q
Mx
A
ursodeoxycholic acid
emoilients
antihistamines for sleeping
10
Q
Mx - if PTT derranged
A
water soluble vitamin K
11
Q
delivery
A
planned delivery after 37wks may be considered if LFTs and bile acids derranged
