?Intrahepatic Cholestasis of Pregnancy ?Cholestatic Jaundice ?IDA

A 30 year old pregnant female presented to OPD with sign and symptoms of Jaundice History She is 8 months ANC Investigations GBP, MP BY RDT, USG W/A are awaited Diagnosis Probable diagnosis in this case? Management Meanwhile she is started on - 1. UDCA 300 BD, 2. Hepamerz sachet BD 3. Hepamerz 1 ampoule in 1 unit DNS once daily 4. Liv 52 DS BD Your advice on this case?

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Homoeopathy medicine Rx, 1) Chelidonium majus 30, 1 drum. Pills. 4tds. 2) Natrum sulph 12x, 4tds For 2weeks

Berberis Vulgaris 3X,Belladonna 3X 3hrly alternate.

Likely progressive HELLP syndrome as platelets are on lower border. Or acute viral hepatitis with hyperbilirubinemia.

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@Dr Ajay Kumar Mishra Sir, Dr @Jayesh Kalbhande sir, @Dr. Shivraj Agarwal Sir, Dr @Vijay Kumar Singh Sir

Agree with Dr. Jayesh Kalbhande sir

Thank you @Dr. Ajeet Singh sir
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Liver dysfunction in pregnancy Differential diagnosis - Acute fatty liver of pregnancy - HELLP syndrome (hemolysis, elevated liver enzymes and low platelets), - Pre-eclamptic liver dysfunction, - Intrahepatic cholestasis of pregnancy (ICP) and - Hyperemesis gravidarum

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My possible differential are AIH or DILI after ruling out biliary obstruction. Although a good retrospective history is needed here. I don’t see any role of liv 52 Increase the dose of UDCA to 450 BD at least . U can consider N ACETYLCYSTIENE if DILI suspected. Get IgM HEV and HAV done. Pls ask for prodromal symptoms or any previous episodes of jaundice or autoimmune disease. ANA and IgG to be done. ICP is diagnosis of exclusion. see whether pruritis is present or not.

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She is a c/o cholestasis jaundice owing to CBD compression due to size of uterus Guide about posture of rest Continue the treatment given Sos ondestron and pantaprazole Sos iv glucose and multivitamin Pt is anaemic so correct the same but iron may aggravates g I problems so be cautious

Thanx dr Ajeet Singh
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Ct all Review after ultrasound report

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