Diagnosis: Pruritus in a pregnant women with healthy skin is suggestive of gravid cholestasis. The diagnosis can only be retained after ruling out viral or drug-induced hepatitis or gallbladder disease. The best markers are maternal serum transaminase and bile acid levels.
Fetal risk: The perinatal consequences of gravid cholestasis are minimal if reasonable premature delivery is accepted.
Therapeutic options: Ursodesoxycholic acid is an interesting therapeutic option if pruritus is untolerable or if the diagnosis is made early in pregnancy. Injection of vitamin K prevents coagulation disorders.