<s>[INST] hello doctor i am 26 weeks pregnant and have severe itching..got a gct done reports are normal,routine urine is also normal..got a liver profile test done and the sgot and sgpt and alp are highly elevated ..the biliruben count is normal.sgot is 194 and sgpt 179..have no nausea or vomitting what can be the problem pleae help [/INST] Hi, Itching in third trimester of pregnancy without any rash or fever points towards, Obstetric homeostasis. You should get your bile salts checked, which can be elevated in obstetric homeostasis. Also, viral markers to rule out infective hepatitis needs to be done. Obstetric homeostasis is unique to pregnancy and subsides after delivery. You will need monitoring of liver enzymes weekly during pregnancy. Rarely, it can affect fetus as well, some doctors consider delivery at 37 weeks to decrease fetal morbidity. Hope this helps. Regards. </s>