Accurate Diagnosis of Obstetric Cholestasis Prevents Fetal Distress

Obstetric cholestasis is the most common liver disease during pregnancy and can cause serious complications. It causes an increase in the level of bile acids in the blood, which results in severe itching, particularly on the palms and soles of the feet. Dietary fats are not absorbed properly causing vitamin K levels to drop, increasing the risk of excessive bleeding in the mother and baby. Obstetric cholestasis is linked to fetal distress, premature labor, and stillbirth, and therefore, accurate and timely diagnosis is crucial.

A bile acids test is the most sensitive test for obstetric cholestasis. The bile acids level rises in other conditions, however, such as acute fatty liver of pregnancy, hepatitis, and liver cirrhosis. Therefore, liver function tests such as alanine transaminase (ALT), alkaline phosphatase, and gamma glutamyl transpeptidase (GT) are necessary to rule out the possibility of other liver conditions. Randox Laboratories' (Crumlin, UK) fifth-generation bile acids assay can be used to diagnose obstetric cholestasis, combined with the company's full range of liver function tests

Treatment for obstetric cholestasis involves frequent ultrasound scans to monitor for fetal distress. Rest and periodic liver tests are recommended for the mother and medications can alleviate the symptoms. Delivery is often induced at around 37-38 weeks to reduce the risk of stillbirth. Obstetric cholestasis spontaneously resolves after the baby has been delivered; this is confirmed by bile acid levels returning to normal.


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