Intrahepatic Cholestasis of Pregnancy

A white female at 32 weeks of gestation presented to the clinic with severe itching that progressively worsened over several days. The patient’s past medical history was unremarkable, and prenatal visits had been normal. The itching began on her palms and soles, spreading to her arms, legs, and torso, significantly disrupting sleep and daily activities. Physical examination revealed no visible rashes or lesions, but the patient’s sclerae were noted to be yellow. The liver was not tender or enlarged, and vital signs were unremarkable. Laboratory results showed elevated serum bile acids, alanine aminotransferase, aspartate aminotransferase, and total bilirubin. The findings suggest intrahepatic cholestasis of pregnancy, a liver disorder marked by intense itching, often without rash, and elevated bile acids. Early diagnosis, treatment with ursodeoxycholic acid, and close monitoring are crucial for preventing complications and ensuring maternal and fetal well-being.