This relatively common disorder apparently results from idiosyncratic exaggeration of normal bile stasis due to hormonal changes

The earliest intense pruritus, develops during the 2nd or 3rd trimester

Dark urine and jaundice sometimes follow

Acute pain and systemic symptoms are absent

The disorder usually resolves after delivery but tends to recur with each pregnancy or with use of oral contraceptives pills.

For severe pruritus, oral cholestyramine "QUESTRAN" 4 to 6 g bid or 3 to 4 g tid is usually effective

Bleeding due to hypoprothrombinemia occasionally develops but is readily reversed by vitamin K (phytonadione) MEPHYTON, 5 to 10 mg IM once/day for 2 to 3 days