RT Book, Section
A1 Usatine, Richard P.
A1 Smith, Mindy A.
A1 Chumley, Heidi S.
A1 Mayeaux, E.J.
SR Print(0)
ID 57674926
T1 Chapter 74. Skin Findings in Pregnancy
T2 The Color Atlas of Family Medicine, 2e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176964-8
LK accessmedicine.mhmedical.com/content.aspx?aid=57674926
RD 2024/04/16
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  74-1).  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