A 34-year-old woman, gravida 3 para 2, presents to the GP at 38 weeks of gestation with a 2-day history of severe generalised itching with no rash. He...

Question

A 34-year-old woman, gravida 3 para 2, presents to the GP at 38 weeks of gestation with a 2-day history of severe generalised itching with no rash. Her bile acid level returns at 22 µmol/L and ALT is 78 U/L. What is the single most appropriate management?

Accepted Answer

Refer for same-day obstetric review to discuss timing of delivery

Answer

Prescribe ursodeoxycholic acid and arrange outpatient obstetric review within 1 week

Answer

Prescribe chlorphenamine and reassure

Answer

Prescribe ursodeoxycholic acid and manage in primary care with weekly bile acid monitoring

Answer

Advise emollients and recheck bile acids in 2 weeks

uk-drcog MCQ (SBA): Obstetric Cholestasis

A 34-year-old woman, gravida 3 para 2, presents to the GP at 38 weeks of gestation with a 2-day history of severe generalised itching with no rash. Her bile acid level returns at 22 µmol/L and ALT is 78 U/L. What is the single most appropriate management?