10th August 2020

A 37-year-old G4P2+1 (pregnant 4 times, with 2 births, 1 miscarriage and 1 current pregnancy), is worried about the itching she has experienced

A 37-year-old G4P2+1 (pregnant 4 times, with 2 births, 1 miscarriage and 1 current pregnancy), is worried about the itching she has experienced, which has affected her sleep. She is 20 weeks into her pregnancy and has had a previous stillbirth. She has found that her palms and soles of her feet are incredibly irritated and itchy. She has no apparent rash on her abdomen, however there are pronounced excoriation marks on her palms and the soles of her feet. She has also commented that her urine looks much darker now compared to before and is worried that she could be dehydrated. Given all the information she has provided, what is the likely diagnosis?

Note: G- Gravidity is the number of times a woman has been pregnant and P- parity is the number of times she has given birth to foetuses with a gestational age of 24 weeks or more irrespective of whether the child is alive or stillborn. The + refers to the number of miscarriages or terminations the woman has had.

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list below.