Review of a challenging clinical issue: Intrahepatic cholestasis of pregnancy

Özkan, Sebiha; Ceylan, Yasin; Özkan, Orhan Veli; Yıldırım, Şule

doi:10.3748/wjg.v21.i23.7134

Cited by 116 publications

(140 citation statements)

References 58 publications

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“…The Cochrane Review found that there was support for UDCA for the relief of maternal pruritus (Gurung et al, 2013;Saleh & Abdo, 2007) and restoring bile acids to a normal state (Saleh & Abdo, 2007), by increasing the biliary secretion that lowers the toxic bile salts, bilirubin (Gabzdyl & Schlaeger, 2015) and liver enzymes in maternal blood (Ozkan et al, 2015). This is further substantiated by a meta-analysis including non-randomized studies conducted by Grand'Maison et al (2014).…”

Section: Pharmacological Treatment Of Icpmentioning

confidence: 96%

“…Maternal outcomes are benign, however, ICP can result in preterm labour, meconium staining, fetal distress and fetal demise (Ozkan et al, 2015) with the greatest to the fetus identified after 37 weeks (Bull et al, 2015). The severity of a case of ICP is defined according to the level of bile acids.…”

Section: Diagnosismentioning

confidence: 99%

“…This liver condition, which presents most often in the third trimester have devastating effects on the fetus, including fetal death (Ozkan, Ceylan, & Yildirim, 2015). The incidence of ICP ranges from 1 case in 1000 to 1 in 10,000 deliveries throughout North America, Asia and Australia (Reyes, 2008).…”

mentioning

confidence: 99%

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Achieving Consensus in the Management of Intrahepatic Cholestasis in Pregnancy

Briglio

Heale

Beites

et al. 2017

DRHJ

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The incidence of intrahepatic cholestasis (ICP) in pregnancy, a liver condition, is increasing, suggesting a greater awareness of the disease. While this condition is an annoyance for a mother, typically causing intense itchiness of the hands and soles of the feet, she will return to normal after delivery. However, this condition has the potential to cause premature delivery, fetal distress and fetal death, so appropriate management is very important. Currently, guidelines available in North America conflict with guidelines in the United Kingdom. The purpose of this research is to establish evidence-based, current practice guidelines for managing cholestasis in pregnancy within a local context. A modified Delphi technique will be utilized with the goal of achieving consensus among local obstetricians about the management of ICP. It is anticipated that two rounds of questionnaires will be disseminated to the group. The content of the questionnaires and the resulting guideline, will take into consideration the unique health care environment and resources in one northeastern Ontario community. Keywords: Intrahepatic Cholestasis in Pregnancy (ICP), E-Delphi, Consensus RésuméLa fréquence de cholestase intrahépatique pendant la grossesse, une affection hépatique, augmente, ce qui suggère une plus grande prise de conscience de la maladie. Bien que cette condition soit un ennui pour une mère, causant habituellement intenses démangeaisons des mains et la plante des pieds, elle va revenir à la normale après l'accouchement. Cependant, cette condition a le potentiel de causer l'accouchement prématuré, la détresse foetale et la mort foetale, ainsi, une gestion appropriée est très importante. Les lignes directrices disponibles en Amérique du Nord s'opposent aux lignes directrices du Royaume-Uni. Cette recherche a pour objet d'établir des lignes directrices fondées sur des données factuelles pour gérer la cholestase pendant la grossesse dans un contexte local. Une technique Delphi modifiée sera utilisée dans le but de parvenir à un consensus parmi les obstétriciens locaux sur la gestion du CIG. Il est prévu que deux séries de questionnaires seront diffusées au groupe. Le contenu des questionnaires et des lignes directrices qui en découlent prendront en considération l'environnement médical et les ressources dans une communauté du nord-est de l'Ontario.

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Section: Pharmacological Treatment Of Icpmentioning

confidence: 96%

Section: Diagnosismentioning

confidence: 99%

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Achieving Consensus in the Management of Intrahepatic Cholestasis in Pregnancy

Briglio

Heale

Beites

et al. 2017

DRHJ

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“…74,75 Şu ana kadar GİK hastalarının izlem ve tedavisinde kesin bir protokol oluşturulamamıştır ve en uygun doğum yaşı için net bir kılavuz yoktur.…”

Section: Gebeli̇ği̇n İntrahepati̇k Kolestazinda Hasta Yöneti̇mi̇unclassified

Gestational Intrahepatic Cholestasis: Etiology, Maternal Outcome, Fetal Outcome and Management: Review

Abide¹,

Vural²

2017

Turkiye Klinikleri J Gynecol Obst

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“…Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder during pregnancy. The incidence of ICP varies geographically from .2 to 2%, being most common in South America and northern Europe . It typically manifests at the late second or third trimester of the pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Intrahepatic cholestasis of pregnancy and comorbidity: A 44‐year follow‐up study

Hämäläinen

Turunen

Mattila

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Intrahepatic cholestasis of pregnancy (ICP) is a reversible liver disorder occurring during pregnancy. It has a typical genetic background with known genetic mutations and can be considered an expression of this genetic predisposition. The objective of this study was to determine whether ICP is associated with specific long‐term comorbidity. Material and methods The study population comprised 571 women with ICP in at least one pregnancy who were compared with 1333 pregnant women without ICP during 1969‐1988 at Tampere University Hospital, Finland. The cohort's follow‐up time was 44 years. All ICD‐10 classification discharge diagnoses were examined for the women in the ICP group from 1998 to 2013 and ICD‐10 diagnoses from outpatient care from 1969 to 2013. Results At least one disease of the digestive system had been diagnosed in 50.4% (288/571) of the ICP mothers compared with 34.4% (459/1333) of the reference group (P < 0.001). In a more detailed analysis, women with a history of ICP had an increased risk for cholelithiasis and/or cholecystitis (odds ratio [OR] 2.88, 95% confidence interval [CI] 2.17 to 3.84), diseases of the pancreas (OR 2.26, 95% CI 1.20 to 4.27) and hypothyroidism (OR 2.38, 95% CI 1.27 to 4.46) compared with the reference group. Arterial diseases were less common in the ICP mothers than in the reference group (OR 0.38, 95% CI .15 to .99). Regarding other diseases, there were no statistically significant differences between the ICP mothers and reference group. Conclusions Half of the women with a history of ICP were diagnosed with at least one disease of the digestive system compared with a third in the reference group. The risk of cholelithiasis, cholecystitis, diseases of the pancreas and hypothyroidism was increased compared with the reference group. These are important facts when counseling women after a pregnancy with ICP. Also, this is of importance for the general practitioners and other physicians who take care of these women.

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Review of a challenging clinical issue: Intrahepatic cholestasis of pregnancy

Cited by 116 publications

References 58 publications

Achieving Consensus in the Management of Intrahepatic Cholestasis in Pregnancy

Achieving Consensus in the Management of Intrahepatic Cholestasis in Pregnancy

Gestational Intrahepatic Cholestasis: Etiology, Maternal Outcome, Fetal Outcome and Management: Review

Intrahepatic cholestasis of pregnancy and comorbidity: A 44‐year follow‐up study

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