All the following are TRUE about cholestasis of pregnancy EXCEPT
INTRAHEPATIC CHOLESTASIS OF PREGNANCY Increases in sex steroid levels causes incomplete clearance of bile acids, which accumulates in plasma Mutations of the ABCB4 gene associated with progressive familial intrahepatic cholestasis, Also drugs causes cholestatic jaundice in pregnant women , like those taking azathioprine following renal transplantation. Hyperbilirubinemia is due to retention of conjugated pigment, but total plasma concentrations rarely exceed 4 to 5 mg/dL. Alkaline phosphatase is usually elevated even more so than in normal pregnancy. Serum aminotransferase levels are normal to moderately elevated but seldom exceed 250 U/L Liver biopsy shows mild cholestasis with bile plugs in the hepatocytes and canaliculi of the centrilobular regions, but without inflammation or necrosis.
Bilirubin more than 5 mg%
Intense pruritis
SGPT , SGOT may be normal
Increased alkaline phosphatase
Physiological Changes of Pregnancy