Obstetric cholestasis

1st July 2011 by Louise Hudman

This is a good overview of the condition. Remember – it is a diagnosis of exclusion.

Features:

  • Pruritus without a rash (except excoriation). It is often worse at night and affects palms and soles too.
  • Cholestatic symptoms (pale stool / dark urine / jaundice)
  • Deranged LFT (transaminases / gamma-GT – bilirubin and bile acids may also be raised). Beware; LFT can take weeks to rise, so if the woman has persistent pruritus, measure LFT every 1 to 2 weeks.

Investigations:

  • To exclude other causes of liver disease – Hep ABC screening, EBV, CMV, Liver autoimmune screen, Coagulation screen

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