A 27 year old primiparous lady presents at 29 weeks of gestation with generalized pruritus for one week. The pruritus is most prominent on the palms and soles and is worse at night.

Her pregnancy has been otherwise uncomplicated. Her medical history is unremarkable for dermatological diseases and allergic conditions.

Her full blood count, renal functions and clotting profile are normal. Her urine tests negative for proteins.