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Intrahepatic cholestasis of pregnancy — DRCOG MCQ

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EasyAntenatal CareIntrahepatic cholestasis of pregnancyDRCOG

A 19-year-old woman at 36 weeks reports intense nocturnal itching of the palms with no rash. What is the most appropriate management?

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Correct answer: BCheck bile acids and liver function tests urgently

Check bile acids and liver function tests urgently is the best answer because the vignette is testing Intrahepatic cholestasis of pregnancy and the recommended approach is consistent with RCOG Green-top Guideline 43. The other options are less suitable because they either delay time-critical assessment, treat a different presentation, or omit the key safety step. Specifically, Offer empirical antifungal treatment; Arrange routine GP review after the next period; Advise rest and hydration at home; Arrange routine review in six weeks would be suboptimal in this scenario. In DRCOG-style primary care questions, the safest answer is usually the step that matches the acuity and gestation rather than symptomatic treatment alone.

Reference: RCOG Green-top Guideline 43