Medical and Surgical Complications in Pregnancy
Cholestasis liver disease of pregnancy ... delivery at (AIIMS MAY. 2010)
1. Obstetric cholestasis or cholestatic jaundice of pregnancy
a. There is 10 to 100 fold increase in bile acids. Pruritus is the most common presenting feature.
b. Onset is generally after 30 weeks of pregnancy. Serum bilirubin rarely exceeds 5 mg/ dl.
c. Serum transaminases are normal to moderately elevated.
2. Maternal consequences include the following:
a. Itching, which can become intense and debilitating
b. Premature labor
c. Deranged clotting, which requires Vitamin K
3. Fetal consequences include:
a. Meconium ingestion
b. Meconium aspiration syndrome
Delivery has been recommended in the 38th week when lung maturity has been established because of risk of IUFD