Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about obstetric colostasis.

And you can find written notes on this topic at zero tofinals.com slash obfes coli or in the antinatal care section of the zero to finals obstetrics and

gynecology book so let's get straight into it obstetric colostasis is also known as intra-hypatic

colistasis of pregnancy coley refers to the bile and the bile ducts and stasis refers to

inactivity. Obstetric colostasis is characterized by the reduced outflow of bile acids from the

liver. The condition resolves after delivery of the baby.

Obstetric colostasis is a relatively common complication of pregnancy occurring in around 1% of pregnant women.

It usually develops later in pregnancy, meaning after 28 weeks gestation,

and is thought to be the result of increased estrogen and progesterone levels.

There seems to be a genetic component so it may run in families and it's more common in women of

South Asian ethnicity. Bial acids are produced in the liver from the breakdown of cholesterol.

These bile acids flow from the liver to the hepatic ducts,

past the gallbladder and out of the bile duct into the intestines.

In obstetric colostasis, the outflow of bile acids is reduced, which causes them to build

up in the blood, resulting in the classic symptom of itching, which is called pruritus.

Obstetric colostasis is associated with an increased risk of stillbirth, where the fetus

dies during the pregnancy.

Let's talk about the presentation.

Obstetric colostasis typically presents later in pregnancy, particularly in the third trimester.

Itching, or pruritus, is the main symptom, particularly affecting the palms of the hands and the souls of the feet.

Other symptoms relating to colostasis and outflow obstruction in the bile ducts include fatigue,

dark urine, pale greasy stools and jaundice, which is a raised bilirubin level which can turn the

...