Obstetric cholestasis

Question 1

What is the prevalence of obstetric cholestasis in England?

Answer 1

0.7%

Question 2

What populations are at higher risk of obstetric cholestasis?

Answer 2

Indian/pakistani

Question 3

What are the maternal symptoms of obstetric cholestasis?

Answer 3

Disturbed sleep and puritis (particularly palms and soles of feet and worse at night), light stools/dark urine

Question 4

What are the potential fetal consequences of obstetric cholestasis?

Answer 4

fetal death and spontaneous preterm birth and increased passage of meconium

Question 5

Risk factors for obstetric cholestasis

Answer 5

Previous OC, family history of OC, multiple pregnancy, ethnicity (pakistani/indian), hep C, gallstones

Question 6

How is obstetric cholestasis diagnosed?

Answer 6

Pruritis with abnormal liver tests (ALT, GGT, bilirubin) and or bile acids with no other clear cause

Question 7

What antibody is used to diagnose autoimmune hepatitis?

Answer 7

Anti-smooth muscle antibody

Question 8

What antibody is used to diagnose primary biliary cirrhosis?

Answer 8

Anti-mitochondrial antibodies

Question 9

How should obstetric cholestasis be monitored?

Answer 9

weekly LFTs until delivery and then 10 days postnatally

Question 10

What would be an indication for giving vitamin k orally to a mother with obstetric cholestasis?

Answer 10

Prolonged prothombin time - give vit K orally 5-10mg daily