Primary cytomegalovirus infection presenting with itching and obstetric cholestasis like picture in mid-trimester

Introduction: We present a case of Primary cytomegalovirus infection presented in midtrimester with itching and obstetric cholestasis like picture. to the best of our knowledge the similarities between primary cMV and obstetric cholestasis, when presenting during pregnancy, have not been highlighted before in the literature. case report: A 36 year old lady presented to antenatal clinic at 23+4 weeks gestational age with intense itching. bile acids and ALt were raised so she was treated as obstetric cholestasis whilst other results were awaited. cytomegalovirus (cMV) antibodies, immunoglobulin G (IgG) and IgM were positive despite being negative at booking, suggesting an acquisition of cMV at approximately 18 weeks gestation. this article highlights the details of her case including the management and consequences of cytomegalovirus in pregnancy. conclusion: this case report highlights the importance of the awareness of the clinicians with the condition as a differential diagnosis to obstetric cholestasis. cMV should be considered