A 28-year-old healthy woman is pregnant since 32 weeks without complications. She takes no medication. Since a number of days she developed increasingly complaints of itch particularly on the palms of the hands and the soles of her feet. At physical examination you see a pregnant, otherwise healthy-looking woman without jaundice and without other skin abnormalities. Blood pressure is 110/70 mm Hg, heart rate 72 per minute. The formerly normal serum lab tests show: total bilirubin 20 μm/L (ULN 17), Alkaline phosphatase 210 U/L (ULN 120), gamma-GT 80 U/L (ULN 40), AST 215 U/L (ULN 40) and ALT 250 U/L (ULN 34). Prothrombin time, IgG and platelets are normal and viral serum markers don’t show viral infection of the liver. Abdominal ultrasound does not disclose any abnormalities of liver, gallbladder and bile ducts.