Obstetric cholestasis

Question 1

Other name for obstetric cholestasis

Answer 1

Intrahepatic cholestasis of pregnancy

Question 2

What occurs in obstetric cholestasis

Answer 2

In obstetric cholestasis, the outflow of bile acids is reduced, causing them to build up in the blood, resulting in the classic symptoms of itching (pruritis).

This is thought to be caused by increased oestrogen and progesteroneW

Question 3

What is a possible risk of obstetric cholestasis

Answer 3

Increased risk of stillbirgth

Question 4

Presentation of obstetric cholestasis

Answer 4

• Pruritis of palms and soles
• Fatigue
• Dark urine
• Pale, greasy stool
• Jaundice
• NO RASH

Question 5

Investigations required in obstetric cholestasis

Answer 5

LFTs and bile acids

Question 6

What causes physiological rise of ALP in pregnancy

Answer 6

The placenta produces ALP

Question 7

Investigation findings in obstetric cholestasis

Answer 7

Raised ALT, AST and GGT
Raised bile acids

Question 8

Management of obstetric cholestasis

Answer 8

Emollients (E.g. calamine lotion)
Antihistamines (Can help sleeping)
Water-soluble vitamin K if prothrombin time raised