Brief Answer:
CHOLESTASIS OF
PREGNANCY - TREATMENT IS REQUIRED.
Detailed Answer:
Hello Mr. XXXXXXX
Thanks for writing to us with your health concern.
I have gone through the reports provided.
Your wife is suffering from a condition known as "
Obstetric Cholestasis " or " ICP -
Intrahepatic Cholestasis of Pregnancy ".
Due to the pregnancy hormone
progesterone, the liver becomes weak in its ability to metabolize and dispose of bile salts .
Due to this, bile salts get deposited underneath the skin surface, leading to itching.
THis condition definitely carries risks - mainly to the baby.
There is a risk of sudden intra uterine death of the baby in this condition, alongwith chance of preterm labour and sudden separation of the placenta leading to bleeding ( abruption ).
For such a patient, I would prescribe Udiliv ( 300 ) twice a day , as it contains the supportive liver enzymes.
ALso, i would prescribe local Lacto
Calamine lotion for application to control itching along with
Cetirizine tablet daily at night.
She should avoid scratching too much .
ALso, the liver function tests should be repeated in a week.
If the report is still the same ( no improvement ) and itching is not relieved, then delivery is indicated at 38 weeks to prevent any risk to the baby.
Also, she should carefully count baby's movements daily.
After breakfast, lunch and dinner , she should lie in the left lateral position for 1 hour ( total 3 hours a day ) and count the movements.
If the total is less than 10, she should report to the doctor.
Also, she should undergo fetal
ultrasound with Colour Doppler to know if the baby is fine.
Take care.
Please feel free to ask for further clarifications.