Itching in pregnancy | Cheat Sheet - Edubirdie

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

404

Pages:

3
Author:

Mariam A. A.

Itching in pregnancy Given the presence of itching and the distribution the most likely and raise in bile acids, the absence of rash and the l The fact that these manifests in the third trimester this strengthens the diagnosis Investigations Non-fasting serum bile acts LFTs FBC Coagulation studies Repeat bile acids weekly to monitor progression Fetal ultrasound for maternal reassurance Exclude: Liver ultrasounds to exclude other causes of hepatic obstruction E.g. gallstones/cholecystitis Viral hepatitis -> viral serology HELLP syndrome -> elevated LFTs, low platelets often with high blood pressure Drug induced Pre-eclampsia Autoimmune liver diseases Management Symptomatic management – antihistamines Ursodeoxycholic acid -> in severe cases to relive itching via reducing bile acid s Vitamin K orally -> because since there is impaired absorption this increase the risk of maternal or fetal haemorrhage Induction of labour at around 37 weeks to reduce risk of stillbirth Maternal Severe pruritic -> sleep disturbances, distress Rare -> coagulopathy due to vit K deficiency Increases risk of post-partum haemorrhage Fetal No increased risk of fetal anomalies Still birth risk increases after 37 weeks especially BA is 100 or more Continuous CTG during labour Pre-term birth Meconium-stained meconium fluid Fetal distress during labour Low birth weight Neonatal respiratory distress There is a high risk of future recurrence -> more than 50%

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