Abnormal liver function tests in pregnancy.

This series of occasional articles provides an update on the best use of key diagnostic tests in the initial investigation of common or important clinical presentations. The series advisers are Steve Atkin, professor, head of department of academic endocrinology, diabetes, and metabolism, Hull York Medical School; and Eric Kilpatrick, honorary professor, department of clinical biochemistry, Hull Royal Infirmary, Hull York Medical School. To suggest a topic for this series, please email us at [email protected]. A 34 year old South Asian nursery worker presented to her general practitioner at 32 weeks’ gestation in her first pregnancy complaining of increasingly severe itching. There was no relevant medical or family history, and she was not taking regular medication. Physical examination was normal with no evident rash. Her blood pressure was 115/65 mm Hg, and there was no proteinuria. The liver function tests were: total bilirubin 6 μmol/L, alkaline phosphatase 178 IU/L, alanine transaminase 42 IU/L, and albumin 34 g/L.