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18th May 2025
A 27-year-old primiparous woman at 32-week gestation presented with right upper quadrant pain, fever and rigors.
A 27-year-old primiparous woman at 32-week gestation presented with right upper quadrant pain, fever and rigors. On examination, she was pyrexic at 38.5°C. Her heart rate 116 beats per minute, blood pressure 130/76 mmHg. She was jaundiced and tender over the liver.
Investigations:
| Haemoglobin | 106 g/L (115–165) |
| White cell count | 15.3 × 109/L (4.0–11.0) |
| Platelet count | 247 × 109/L (150–400) |
| Prothrombin time | 15.2 (11.5-15.5) |
| INR | 1.3 (<1.4) |
| Serum sodium | 140 mmol/L (137–144) |
| Serum potassium | 3.2 mmol/L (3.5–4.9) |
| Serum urea | 9.0 mmol/L (2.5–7.0) |
| Serum creatinine | 125 μmol/L (60–110) |
| Serum albumin | 33 g/L (37-49) |
| Serum total bilirubin | 120 µmol/L (1–22) |
| Serum alanine aminotransferase | 210 U/L (5–35) |
| Serum aspartate aminotransferase | 100 U/L (1–31) |
| Serum alkaline phosphatase | 578 U/L (45-105) |
| Serum gamma glutamyl transferase | 854 U/L (4-35) |
What is the most appropriate management?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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