Obstetric Cholestasis Flashcards
1
Q
What is cholestasis again?
A
A decrease in bile flow due to:
- impaired secretion by hepatocytes
- obstruction of bile flow through intra-or extrahepatic bile ducts.
2
Q
S+S:
- Main symptom - 1
- Why may it lead to sleep loss?
- Other signs of cholestasis? - 3
A
Pruritis (palm, soles) - worse at night
Pale stool
Dark urine
Jaundice
3
Q
How is it diagnosed?
A
Diagnosis of exclusion - test for hepatitis, autoimmune screen, USS of liver
4
Q
Rx:
- For abnormal clotting screen for both mother and baby when it’s born?
- For itch and abnormal LFTs?
- What can be used to cause drowsiness and help with sleep?
How long does it take for this to recover after birth?
What is the only definitive cure for severe disease?
A
Vitamin K PO - IM for baby (standard)
Ursodeoxycholic acid
A few days
Antihistamines - use guidelines - diphenhydramine
Induction at 37 wks
5
Q
Monitoring:
Why should LFTs and bile acid be checked every 2 wks?
A
A woman might have unexplained itching but no LFT or bile acid changes
