IntroductionObstetric cholestasis (also known as intrahepatic homeostasis of pregnancy (ICP), is the most common liver disease during pregnancy (Glatz, Marschall, Mattsson 2004). It is a multifactorial condition specific to pregnancy and is characterized by puritis, an elevation in serum levels of aminotransferases and bile acids, appearing during the second or third trimester. of pregnancy, with spontaneous relief of signs and symptoms within two to three weeks after delivery (Beuers and Pusl 2006), a relatively benign but often maternally distressing condition, the clinical importance of obstetric cholestasis lies. in potential fetal risk, which can include preterm labor, fetal distress, and stillbirths (Egan, Bartels, Kashan, Broadhurst, Joyce, Mullane, & O'Donoghue 2012). Diagnosis is suggested if a woman is in the third trimester (well although a previous presentation has been suggested Saleh and Abdo 2006) develops itching without rash and at least one hepatic biochemical abnormality (Walker, Nelson-Piercy and Williamson 2002), the RCOG (2006) recognizes ICP as a diagnostic exclusion, therefore other more common causes of liver function test (LFT) disorders should be excluded. This includes pre-eclampsia, acute fatty liver disease, infectious and autoimmune hepatitis, and choledocholithiasis (Seong and Valayatham 2013). An increase in liver enzymes (Alanine Transfinite (ALT) and an increase in serum bile acids (SBA) generally confirm the diagnosis of ICH (Kenyon, Pier, Girling, Williamson, Tribe and Shennan 2002), with measurement of SBA being considered the most important biochemical marker for the diagnosis and monitoring of ICP In the case of Mrs. Hepatic recirculation means that each bile salt molecule is reused approximately 20 times. Hepatocytes initiate bile formation by secreting primary bile, into their canaliculi, because bile canaliculi have a high surface volume ratio due to its size. ergonomic structure, it promotes, by means of osmotic gradients, the formation of the bile flow The cholangiocytes modify the bile canaliculi by a process of secretion and reabsorption as the bile passes through the bile ducts (Banales, Prieto, Medina 2006). The composition of bile is mainly. water, but phospholipids, cholesterol and ions including sodium, potassium and calcium are all identified, as are proteins and peptides such as gluthione (Esteller 2008) and a small proportion of bile salts 0.6 g (Brites 2002). Bile salts and bile acids synthesized by the liver from cholesterol with the organic acid taurine or the amino acid choline