Abstract
Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder characterized by (i) pruritus with onset in the second or third trimester of pregnancy, (ii) elevated serum aminotransferases and bile acid levels, and (iii) spontaneous relief of signs and symptoms within two to three weeks after delivery. ICP is observed in 0.4–1% of pregnancies in most areas of Central and Western Europe and North America, while in Chile and Bolivia as well as Scandinavia and the Baltic states roughly 5–15% and 1–2%, respectively, of pregnancies are associated with ICP. Genetic and hormonal factors, but also environmental factors may contribute to the pathogenesis of ICP. Intrahepatic cholestasis of pregnancy increases the risk of preterm delivery (19–60%), meconium staining of amniotic fluid (27%), fetal bradycardia (14%), fetal distress (22–41%), and fetal loss (0.4–4.1%), particularly when associated with fasting serum bile acid levels > 40 μmol/L. The hydrophilic bile acid ursodeoxycholic acid (10–20 mg/kg/d) is today regarded as the first line treatment for intrahepatic cholestasis of pregnancy. Delivery has been recommended in the 38th week when lung maturity has been established.
Highlights
Intrahepatic cholestasis of pregnancy relief of signs and symptoms within two to three weeks after delivery [1,2]
Intrahepatic cholestasis of pregnancy (ICP) is a cholestatic disorder characterized by pruritus, elevated serum aminotransferases and bile acid levels with onset in the second or third trimester of pregnancy, and spontaneous
The incidence of ICP was highest in Bolivia and Chile several decades ago, among the Araucanos Indians of Chile (27.6%) and the Aimara Indians of Bolivia (13.8%) [5,6,7,8], but has considerably decreased in these countries more recently to less than 2% of all births today
Summary
Berichte und Arbeiten aus der geburtshilflich-gynaekologischen Klinik zu Giessen 1881-1882. 4. Germain AM, Carvajal JA, Glasinovic JC, Kato CS, Williamson C: Intrahepatic cholestasis of pregnancy: an intriguing pregnancyspecific disorder. 5. Reyes H, Gonzalez MC, Ribalta J, Aburto H, Matus C, Schramm G, Katz R, Medina E: Prevalence of intrahepatic cholestasis of pregnancy in Chile. 6. Reyes H, Taboada G, Ribalta J: Prevalence of intrahepatic cholestasis of pregnancy in La Paz, Bolivia.
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