Obstetric cholestasis

Abstract

Obstetric cholestasis (OC) is associated with significant perinatal mortality and maternal morbidity. Fetal outcome may be improved with increased antenatal surveillance and timely intervention. Frequently attributed to the Scandinavian authors Alvar Svanborg and Leif Thorling, the first case report was by Ahlfeld in 1883 who elegantly described recurrent jaundice in a pregnant patient that remitted with delivery. During the 1950's various terminologies originated describing some of the characteristic features of the disease: icterus gravidarum, cholestatic hepatosis and recurrent jaundice during pregnancy, all synonymous with ‘obstetric cholestasis.’ Ahlfeld's original patient did not complain of itching but over the recent years pruritis has become the commonest manifestation. Obstetric cholestasis is the most common disorder of liver function unique to pregnancy and second only to acute viral hepatitis as a cause of jaundice in the third trimester.