Obstetric cholestasis is typically suspected when a pregnant woman presents with generalized pruritus without a rash. Biochemically, only a mild abnormality of liver function tests is seen without any systemic signs and symptoms. The patient is usually treated with Ursodeoxycholic acid which improves both pruritus and liver function tests. We present a case where a pregnant woman presented with pruritus and was found to have unusually high levels of serum transaminases. The diagnosis of obstetric cholestasis was made only by exclusion of other causes of hepatobiliary dysfunction. Fortunately the condition responded well to the standard treatment and both mum and baby had a favourable outcome.
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