Obstetric Cholestasis (OC) diagnosis and management guideline Page 5 of 10 See the Intranet for the latest version. The median gestation at onset of pruritus was 30 (range 4–39) weeks and at diagnosis of obstetric cholestasis was 33.7 (range 21–40.7) weeks. If you have obstetric cholestasis during one pregnancy, there is a high risk that it may happen again in a future pregnancy. Obstetric cholestasis cases (n = 87) The median week of onset of pruritus was 33 weeks gestation (interquartile range [IQR] 30–35 weeks). More guidelines. A revised version of the Accreditation Standards and Guidelines for Hospitals in the FRANZCOG Training Program will come into effect from 1 February 2021. affected by obstetric cholestasis. The American College of Obstetricians and Gynecologists is the premier professional membership organization for obstetrician–gynecologists. Use … Recommendations: 1. Know the causes and treatment. Intrahepatic cholestasis of pregnancy (ICP) is a poorly understood disease of the late second or third trimester of pregnancy, typically associated with rapid resolution following delivery. Obstetric cholestasis (OC), sometimes called cholestasis of pregnancy, is a liver disorder that a small number of pregnant women can develop, usually in the last three months (last trimester) of pregnancy. There seems to be a genetic component. Version Number: 5 Chlorphenamine 4mg TDS orally may relieve itching, patients should be warned about its sedating effects. Patient leaflets. Women with obstetric cholestasis should be closely monitored 3. It is characterized by pruritis, elevated serum bile acids, and abnormal liver function tests and has been linked to stillbirth, meconium passage, respiratory distress syndrome and fetal asphyxial events. This guideline provides guidance for midwives, medical and support staff on the different management choices and treatment options. Introduction. May be associated with an increased risk of adverse pregnancy outcomes, including premature birth, intrauterine fetal demise, and placental abruption in severe disease. Clinical guidelines under review remain the current endorsed clinical guideline until the review is complete. 6. Obstetric cholestasis is the main cause of itch without a rash in pregnancy. 14/12/2020. Intrahepatic cholestasis of pregnancy/ obstetric cholestasis after the birth Most women can stop taking UDCA immediately after their baby has been born. Endorsed Maternity Services Division LOPs group 11/9/12 . BJOG 2002;109:282-8 . In April 2011, the Royal College of Obstetricians and Gynaecology (RCOG) (1) updated the obstetric cholestasis guidelines regarding treatment with vitamin K due to BNF recommendations of avoiding water soluble vitamin K (menadiol sodium phosphate) therapy late in pregnancy and labour because ‘The specific dermatoses of There has since been an Obstetric cholestasis is more common in women from certain ethnic groups, particularly those from South American and Scandinavian regions. ACT Registrar Research Day. Obstetric cholestasis should be accurately diagnosed 2. The clinical importance of obstetric cholestasis lies in the potential fetal risks, which may include spontaneous preterm birth, iatrogenic Cholestasis of pregnancy makes an expectant mom very itchy, and it can be dangerous for her baby. Manzotti C, Casazza G, Stimac T, et al. Obstetric cholestasis has also been found to run in some families. Obstetric cholestasis is a rare condition that only affects you if you are pregnant. Edinburgh:Churchill Livingstone; 2004.p. Women aged 18 or older at 20 to 40 weeks, 6 days gestation with a singleton or twin pregnancy, and no known lethal fetal anomaly who had intrahepatic cholestasis were recruited. Obstetric outcome was recorded. The itch (often severe) usually starts abruptly in the third trimester, is often more noticeable on the soles and palms but can occur anywhere on the body, and may be worse at night. Obstetric Cholestasis (OC) is a multifactorial condition of pregnancy characterised by intense pruritus in the absence of a skin rash, with abnormal liver function tests (LFTs), which resolves following birth. The Royal College of Obstetricians and Gynaecologists issue a guideline “Obstetric Cholestasis”. The active management and induction of labor, undertaken because of the risk of intrauterine fetal death (IUFD), may be responsible for higher prematurity rates. 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