CHOLESTASIS OF PREGNANCY
By Gary M. White, MD
Cholestasis of prengancy (CP) causes intense itching usually in the third trimester.
- There is no primary lesion.
- Elevated total serum bile acid is found.
- CP is associated with prematurity, fetal distress and still births
Itching typically starts later in the pregnancy. It may first be noticed on the palms and soles, but later, generalizes. Approximately 10% of patients develop jaundice. There is a risk of recurrence in future pregnancies and with the use of oral contraceptives. Twin pregnancy is associated.
The bile acid level is elevated. LFTs are abnormal in 30% of cases. Hyperbilirubinemia may occasionally be seen.
Referral to a specialist is in order. Oral ursodeoxycholic acid has been used. The itching resolves soon after delivery.
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