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Pregnant, severe itching around hand, palms and feets, elevated SGOT, SGPT. Reasons ?

Hi, My wife is 38th week of pregnancy and she is due in next 1 week. For the past 1 week she is having higher level of itching around hand palms and solefeets..Her SGPT and SGOT are more than 3 times (roughly about 160 & 220)..Other parameters in the LFT &CBC are completely fine...could you advise on reason for huge increase in SGPT / SGOT and also its effects on both mom and baby..
Asked On : Wed, 27 Feb 2013
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General & Family Physician 's  Response
Dec 2012

Thanks for posting on HCM,

Your wife is most likely suffering atypical form of acute fatty liver of Pregnancy/AFLP (given that she is not having other presenting symptoms such as nausea, vomiting, stomach ache, jaundice etc) and maybe still at its early stage and will surely require urgent medical attention. The transaminases (SGPT, SGOT) might stabilize within a couple of weeks to a few months but then in-patient management of your wife's condition is necessary. Other possible cause may be fulminant viral hepatitis, drug-induced hepatic toxicity, idiopathic cholestasis of pregnancy, adult-onset Reye syndrome, and HELLP syndrome. These are all very severe medical conditions that require close attention and management.
Risk factors for AFLP include older maternal age, primiparity, multiple gestations, preeclampsia, male fetus, being underweight, and a history of AFLP.
Other laboratory investigations should be done such as screening for diabetes, kidney function tests, platelet count ( i assume already done with CBC), viral hepatitis screening, CT scan or abdominal ultrasound. Your wife's BP should be checked.
Since she is already at term, it is best if your wife's gynobs start envisaging delivery by induction as soon as possible. This condition is typical between 27th-40th week as published by many authors.

Hope this information helps and serves a purpose.
Dr Nsah
Answered: Tue, 5 Mar 2013
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