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 Best of Five 143

 

   

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BOF: 143

A 28-year-old female of Scandinavian origin presents with intense pruritus in her third trimester of pregnancy. Clinically there are no abnormalities apart from scratch marks.

Investigations reveal:

ALT 120 U/L

Alkaline phosphatase 350 U/L

Serum bilirubin 60 micromoles per litre

Hb 11.0g/dL

WBC 4.3 x109 /l

Platelets 250,000 x 109/l

In this patient the next step should be:

a)      Immediate delivery of the baby

b)      Ursodeoxycholic acid

c)      Cholestyramine

d)      Liver biopsy

e)      Steroids and azathioprine

 

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