Which of the following is the investigation of choice in cholestasis of pregnancy?
In patients with cholestasis of pregnancy the levels of serum bile acids are elevated 30-100 times the upper limit of normal. Levels of AST, ALT and alkaline phosphatase are only mildly elevated. Intrahepatic cholestasis of pregnancy: The major risk factors for IHCP include multiparity, advanced maternal age, family history of IHCP, and pruritus while on oral contraceptive medicines. Patients often presents in the third trimester of pregnancy with pruritus beginning centrally and spreading peripherally. 20% develop pruritus and jaundice. Ursodiol and cholestyramine are the first agents of choice in the treatment of pruritus. Ref: Ukomadu C. (2012). Chapter 8. Hepatic Complications of Pregnancy. In N.J. Greenberger, R.S. Blumberg, R. Burakoff (Eds), CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 2e
Serum bilirubin levels
Serum bile acids levels
Serum alkaline phosphatase levels
Serum glutathiones transferase levels