A total bile acid of 49.8 mmol/L during pregnancy is already severe intrahepatic cholestasis in pregnancy, and the condition is relatively serious. Bile acids can be transferred to the fetus through the placenta, leading to chronic intrauterine hypoxia and even fetal death in severe cases. When the total bile acid in pregnancy is more than 40mmol/L, it is already severe intrahepatic cholestasis in pregnancy. In addition to the high total bile acid, this kind of patient may also have abnormal fetal movement, itchy skin, yellowish skin, or elevated aminotransferases, etc., and then it is necessary to be hospitalized in time for treatment. After admission to the hospital, we will continue to improve fetal cardiac monitoring, ultrasound, routine blood tests, hepatitis and autoimmune liver and other tests to detect the condition of the pregnant woman, and actively give ursodeoxycholic acid acid treatment to reduce acidity, and terminate the pregnancy if necessary, so as not to cause adverse pregnancy outcomes.