Intrahepatic cholestasis of pregnancy

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Intrahepatic cholestasis of pregnancy
Synonyms	Obstetric cholestasis
Pronounce	N/A
Specialty	N/A
Symptoms	Pruritus, jaundice, fatigue
Complications	Fetal distress, preterm birth, stillbirth
Onset	Third trimester
Duration	Until delivery
Types	N/A
Causes	Genetic predisposition, hormonal changes
Risks	Multiple pregnancy, previous history of cholestasis, liver disease
Diagnosis	Liver function tests, serum bile acid test
Differential diagnosis	Acute fatty liver of pregnancy, HELLP syndrome, viral hepatitis
Prevention	None
Treatment	Ursodeoxycholic acid, early delivery
Medication	Ursodeoxycholic acid, antihistamines
Prognosis	Good with treatment
Frequency	1 in 140 pregnancies
Deaths	N/A

Intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis, is a liver disorder that can develop during pregnancy. This condition affects the normal flow of bile, a digestive fluid produced in the liver, causing it to build up in the body and leading to symptoms such as itching and jaundice.

Symptoms

The most common symptom of ICP is severe itching (pruritus), particularly on the palms of the hands and soles of the feet, although it can also occur on other parts of the body. This itching is often worse at night and can be so severe that it interferes with sleep. Other symptoms can include dark urine, pale stools, and jaundice (yellowing of the skin and whites of the eyes).

Causes

The exact cause of ICP is not known, but it is believed to be related to hormonal changes that occur during pregnancy. These changes can affect the liver's ability to transport certain substances, including bile acids, which can then build up in the liver and spill over into the bloodstream.

Diagnosis

ICP is typically diagnosed through a combination of symptom assessment, physical examination, and laboratory tests. These tests can include blood tests to measure levels of bile acids and liver enzymes, as well as imaging tests such as ultrasound to check for any physical abnormalities in the liver.

Treatment

Treatment for ICP focuses on relieving symptoms and preventing complications. This can include medication to reduce bile acid levels and itching, as well as regular monitoring of the baby's health. In some cases, early delivery may be recommended to reduce the risk of complications.

Prognosis

With appropriate treatment and monitoring, most women with ICP and their babies do well. However, ICP can increase the risk of certain complications, including preterm birth, fetal distress, and stillbirth. Therefore, close monitoring and appropriate management are essential.

See also

• Pregnancy
• Liver disease
• Cholestasis
• Bile

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