MSRA-0834

MSRA-0834

A 28-year-old pregnant woman presents to the GP with jaundice and itchy skin for the past 2 weeks. She claims that is a lot worse during this pregnancy compared to her last one. History reveals that she is currently 30 weeks pregnant with no complications up until presentation.

On examination, the only notable findings are mild jaundice seen in the sclerae, as well as excoriations around the umbilicus and flanks. She denies any tenderness in her abdomen during the examination. Blood tests show the following:

ALT 206 U/L
AST 159 U/L
ALP 796 umol/l
GGT 397 U/L
Bilirubin (direct) 56 umol/L
Bile salts 34 umol/L
Bile salts reference range 0 – 14 umol/L

What is the most likely diagnosis?