A 24-year-old woman at 30 weeks of gestation in her first pregnancy is noted to be mildly jaundiced, to have dark urine, and to have pruritus of her a

Subject
Obstetrics and Gynaecology
System
Pregnancy, Childbirth & Puerperium

Kathryn

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Jul 29, 2020
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A 24-year-old woman at 30 weeks of gestation in her first pregnancy is noted to be mildly jaundiced, to have dark urine, and to have pruritus of her abdominal skin. Her BP is 130/80mmHg, the fundal height measures 29cm above the pubic symphysis. and the liquor volume appears slightly less than would be expected. Blood tests were arranged and gave the following results:
Serum bilirubin (unconjugated) : 5umol/L (0-10)
Serum bilirubin (conjugated) : *12umol/L (0-5)
Serum alkaline phosphatase (ALP) : *450U/L (30-350)
Serum alanine aminotransferase (ALT) : 45U/L(<55)
Serum bile acids : *100umol/L (1-26)
Which one of the following is the most likely cause for these symptoms and results?

(A) Acute fatty liver of pregnancy
(B) Obstetric cholestasis
(C) Pre-eclampsia
(D) Cholelithiasis
(E) Viral hepatitis A
 
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