obstetrics

Question 1

itch 32 weeks pregnancy differentials?

Answer 1

obstetric cholestasis and rash from infection, eczema,prurito urticarias papules and plaques of pregancy.
physiological:
liver worse at night hands and feet obs cholestasis hep C
PBC

Question 2

what can give you abnormal lfts?

Answer 2

hyperemesis, hepatitis, obs cholestasis, Helpp syndrome, ebb cmv, drug induced

alkaline phosphatase raised in pregancy
fasting bile acids

Question 3

mgx obstetric cholestasis?

Answer 3

fetal risks- risk of pph and increased of stillbirth, passage of meconium and fetal delivery.
ursodeoxycholic acid and antihistamine piriton
water soluble vit. k
offer induction after 37 weeks

Question 4

follow up for obs cholestasis?

Answer 4

lfts back to normal at the postnatal check 6 wks
high risk of recurrence
avoid oestrogen contraception