Pathology Handbook

Bile Acids

Clinical Indications

Serum bile acids have been shown to be a sensitive test of hepatobiliary dysfunction. They may be useful in the diagnosis of obstetric cholestasis (OC), especially in the presence of normal LFT's.

Incidence of OC appears to be increasing (~0.2%) and is characterised by severe pruritis, which usually develops in the third trimester. Associated risks include increased risk of maternal postpartum haemorrhage (due to disruption of the absorption of fat soluble vitamin K) and a higher rate of IUD, especially perinatal death after 36 weeks.

Request Form

Request on ICE


On request on pregnant patients only

Specific Criteria

Investigation of suspected obstetric cholestasis; repeat samples will be analysed after at least one week.

Turnaround Time

Same day


Serum in gold-top vacutainer


2 ml


Vacutainer gold top

Causes for Rejection

Unlabelled or incorrectly labelled sample; not meeting specific criteria for analysis

Reference Range

Less than 14 umol/L