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Icterus Cholestatic in Pregnant Women : A Case Report (Ikterus Kholestatik pada Wanita Hamil : Suatu Laporan Kasus)

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In six years nine cases with jaundice in the 3rd trimester of pregnancy, have been found seven had intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis of hepatosis of pregnancy, and two had suspecious acute fatty liver of pregnancy (AFLP). The age range from 19 to 27 years, with a mean age of 23.1 years old. Seven cases with ICP had a chief symptoms of pruritus partcularly at night, followed after two weeks by jaundice. There were no symptoms of nausea, vomiting, anorexia, abdominal pain. Three cases had recurrent episodes of pruritus and jaundice in previous pregnancy. Four cases develop pruritus on receiving oral contraceptives. Premature delivery occurs in two cases. Laboratory examination reveal, serum bilirubin especially direct reacting bilirubin, alkaline phosphatase, serum transaminase and serum bile acids are increased. Immediately after delivery, all liver function test start to decrease. Two cases with suspecious AFLP had chief symptoms of abdominal epigastric pain, nausea, vomiting and jaundice develop within a few days. There were no symptoms of fever and pruritus. One case had hematemesis, and the other case had severe headache. All two cases were primipara, obese, high blood pressure, and death after two weeks of illness. Laboratory findings reveal leucocytosis, thrombocytopenia, liver functions test are elevated (serum bilirubin especially direct reacting bilirubin, serum transaminase, alkaline phosphatase), also blood urea nitrogen, cretinin and uric acid levels are increased. It is concluded that ICP is a benign condition and premature delivery occurs at about 30 percent of cases. AFLP is a potentially fatal disorder that may be fatal on the third trimester of pregnancy.

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Majalah Kedokteran Bandung,27(3)1995:88-94

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: ., 1995

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pregnancy
cholestasis

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