By Gary M. White, MD

Cholestasis of prengancy (CP) causes intense itching usually in the third trimester.


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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