In plain words
Total serum bile acids is a blood test that measures bile acids, which the liver makes to help digest fat. In pregnancy, the level can rise when bile flow from the liver slows. This is a feature of , a liver condition that usually brings intense , often on the palms and soles and worse at night. The test is one part of the diagnosis, along with symptoms and liver tests. A raised result is taken seriously because of possible effects on the baby. The test does not measure every itch, and itching without a raised result still needs a check. Call your provider the same day if you have new, intense itching.
The deeper version
Total serum bile acids are a standard serum measurement in the diagnosis of intrahepatic cholestasis of pregnancy (ICP). ICP presents as pruritus without primary skin lesions, typically palms and soles first and worst at night, with elevated total serum bile acids. SMFM (2021) uses 10 micromoles per liter or more as the diagnostic threshold, with 40 and 100 as severity tiers, and transaminases are often mildly raised. Higher levels are associated with risk, which underlies timed-delivery discussions in severe cases. Whether treatment benefits mild ICP is debated.
Where it comes up
- Itching that won't stop: cholestasisPregnancy: Your Body
- Skin in pregnancy: stretch marks, linea nigra, melasma, itchingPregnancy: Your Body
What mothers here say about total serum bile acids
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Sources
- Society for Maternal-Fetal Medicine — Consult Series #53: Intrahepatic Cholestasis of Pregnancy, 2021
- Royal College of Obstetricians and Gynaecologists — Obstetric Cholestasis, Green-top Guideline No. 43, 2011