Obstetric cholestasis — an overview

Obstetric cholestasis is a liver condition which occurs only in pregnancy and disappears shortly after the delivery. Typical clinical symptom of obstetric cholestasis is an intractable pruritus which usually presents itself in the third trimester of pregnancy. Jaundice occurs only in about 10% of patients. Laboratory investigations typically show elevated levels of total bile acids. Obstetric cholestasis does not pose a mortality risk to the mother however, it is responsible for a premature delivery in 19–60% of affected females. In 1–4% of cases it may lead to foetal death. First choice of medications is ursodeoxycholic acid. In view of the fact that an intrauterine death of the foetus usually takes place after 37– –38 week of gestation it is frequently advised to induce delivery in these patients in the 36 th week of pregnancy.