RT Book, Section
A1 Mayeaux, Jr., E.J.
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164351130
T1 Skin Findings in Pregnancy
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK accessmedicine.mhmedical.com/content.aspx?aid=1164351130
RD 2024/04/20
AB A  32-year-old  G3P2  woman  presents  with  persistent  itching  in  her  31st  week  of  pregnancy.  The  itching  is  constant  and  worse  at  night.  Her  pregnancy  had  been  uncomplicated,  and  she  has  no  past  history  of  medical  problems.  Many  excoriations  are  noted  and  there  are  no  blisters  (Figure  76-1).  She  has  no  jaundice  or  scleral  icterus.  Her  transaminases  were  greater  than  300  and  her  total  bilirubin  was  elevated  at  2.1.  Her  bile  salts  were  elevated  and  her  hepatitis  panel  was  negative.  The  ultrasound  showed  gallstones,  but  no  obstruction  was  seen.  A  diagnosis  of  "intrahepatic  cholestasis  of  pregnancy"  was  made,  and  the  patient  was  treated  with  oral  ursodiol  (a  bile  salt  binding  agent)  and  topical  1%  hydrocortisone  cream.  The  bile  salts  and  transaminases  were  decreased  and  the  patient's  pruritus  improved  but  did  not  resolve  until  after  delivery.1