BPS Government Medical College for Women, India
Posters & Accepted Abstracts: Clin Exp Dermatol Res
A liver condition in which normal flow of bile is impaired resulting in severe itching in pregnancy and affects about one in 140 pregnancies. It involves only secondary skin changes caused by disruption of hepatic bile flow during pregnancy and presents in second or third trimester with sudden onset of severe pruritis that starts on the palms and soles and quickly becomes more generalized. Worst at night linear excoriations and excoriated papules and develop secondary to scratching. Jaundice occurs in about 10 percent often accompanied by dark urine and clay colored stools. Diagnosis requires taking a thorough history and complete physical examination, laboratory studies such as liver transaminases, serum bile acid levels and in selected cases skin biopsy is necessary. An accurate diagnosis must be made owing to the fact that some of these conditions are associated with complications for both mother and fetus. There are elevated bile acid levels in serum which can pass into fetal circulation and affect the fetus owing to acute placental anoxia and cardiac depression. Pruritis regresses spontaneously within days to weeks after delivery but can recur in subsequent pregnancies or while using hormonal contraception. Treatment consists of reducing bile acids with the use of ursodeoxycholic acid and anti-histaminics and may require termination of pregnancy at 36-38 weeks.
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