Obstetric cholestasis

Question 1

How common is obstetric cholestasis?

Answer 1

1% of pregnancies. Generally seen in 3rd trimester

Question 2

Symptoms of obstetric cholestasis

Answer 2

• Pruritis - worse at night, more intense over pals and soles
• Jaundice

Question 3

How is obstetric cholestasis?

Answer 3

Abnormal LFTs and intense pruritis in absence of skin rash and any other cause for abnormal LFTs.

Question 4

Managment of obstetric cholestasis

Answer 4

• Antihistmaines eg Chlorophenamine (control pruritis)
• Urseodeoxycholic acid - symptomatic releif
• Vitamin K supplementation
• Induce labour - typically at 37 weeks

Question 5

Complications of obstetric cholestasis

Answer 5

• Maternal
  
  • PPH (reduced vit K)
• Foetal
  
  • Pre-term labour
  • Foetal distress