3 Days in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#455

SMLE Question #455

Obstetrics & Gynecology General Gynecology
Last updated: February 2026
A 29-year-old primigravida at 34 weeks’ gestation has 2 weeks of severe generalized pruritus worse at night, followed by jaundice and dark urine for 3 days. Examination shows jaundice and excoriations. The obstetrician suspects intrahepatic cholestasis of pregnancy and wants to confirm the diagnosis and assess maternal risk. What is the most important laboratory investigation to obtain for the mother at this time?

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