Intrahepatic Cholestasis of Pregnancy

Pregnancy-Associated Liver Disorders

“…One should be especially watchful for vitamin K deficiency that could be quite hazardous in the light of future delivery and potential bleeding. Jaundice is an uncommon presenting feature, but can occur later (10-20% of patients) and is usually mild [3,106].…”

“…Sudden intrauterine fetal death may occur without any early signs of fetal distress on fetal monitoring. To date, no ideal screening test has been established for antenatal fetal monitoring in the setting of ICP [106]. The total serum bile acid level seems to be a better predictor of fetal distress than biophysical profile or nonstress testing.…”

“…Fetal benefits include facilitation of closer to term delivery and reduction of bile acid concentration in the colostrum. It is usually well tolerated and no adverse effects to the fetus or teratogenicity with UDCA administration has been reported [71][72][73]106].…”

“…In severe cases, when jaundice is present or total bile acid concentration is greater than 40 lM/l, delivery as early as 36 weeks is advisable, if lung maturity permits [106,118].…”

Intrahepatic Cholestasis and Eclampsia: A Case Report

“…In addition, cholestasis may be a response to the production of abnormal metabolites. Genetic predisposition suggests a complex trait, and an exaggerated cholestatic response to estrogen has been documented in women from families affected by ICP (3). The course and severity of ICP are variable, but the classical maternal feature is generalized pruritus, becoming more severe with advancing gestation and fortunately resolving spontaneously after delivery.…”