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Intrahepatic cholestasis of pregnancy — DRCOG MCQ

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ModerateAntenatal CareIntrahepatic cholestasis of pregnancyDRCOG

A 30-year-old woman at 34 weeks reports intense itching of her palms and soles, worse at night. There is no rash. Her urine dipstick is normal and fetal movements are normal. What is the most appropriate investigation?

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Correct answer: B — Liver function tests and serum bile acids

Intrahepatic cholestasis of pregnancy commonly presents with pruritus without rash, particularly affecting palms and soles. Liver function tests and bile acids are the appropriate initial investigations. A fungal or allergic work-up is not the priority when the history is classic for cholestasis. The pearl is that bile acids guide both diagnosis and risk stratification.

Reference: NICE NG201; RCOG Green-top Guideline No. 43