Cholestasis

Question 1

Is likelihood of IUFD related to severity of Intrahepatic Cholestasis?

Answer 1

Yes

Question 2

Consensus in clinical practice is to encourage delivery at?

Answer 2

37 weeks regardless of severity, however optimal timing has not been established by ACOG

Question 3

Clinical features of cholestasis are:

Answer 3

Classically presents in the third trimester with pruritus, typically of the palms and soles (often worse at night), abnormal liver function, and raised serum bile acid levels

Question 4

Risk factors of cholestasis are:

Answer 4

1-  AMA
2- IVF
3- Multifetal Gestation
4- Hepatitis C
5- ICP History (family or personal)

Question 5

DD of cholestasis:

Answer 5

1- PUPP (Polymorphic eruption of pregnancy)
2- Viral Hepatitis
3- Pemphigoid
4- Contact Dermatitis
5- AFLP

Question 6

Therapy of Cholestasis?

Answer 6

Ursodeoxycholic Acid 300mg tid (for symptoms)
Delivery at 37 weeks
NSTs twice weekly

Question 7

Therapy of PUPPs?

Answer 7

Triamcinolone 0,1% Cream