PMC8440103_01
(a) Trend in bile acid levels. (b) Trend in liver profile values. (c) Trend in bilirubin levels (note: "postpartum" refers to 12 days following delivery).
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The follow-up plan during her pregnancy included liver profile and bile acid monitoring every 2 to 4 weeks (Figures 1(a) and 1(b)), weekly bilirubin checks (Figure 1(c)), serial growth ultrasounds every 4 weeks, nonstress tests twice weekly starting at 32 weeks of gestation, and ultimately delivery via induction of labor at 36 to 37 weeks and pending maternal and fetal status. TSBA levels, the patient's UDCA dose was increased to 600 mg 3 times daily (15 mg/kg/day) (Figure 1). The plan was then to schedule induction of labor at 36 weeks with administration of 2 doses of betamethasone before her scheduled induction. Her liver enzymes remained elevated (Figure 1(b)).