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Cholestasis of Pregnancy: A Review of the Evidence

Nichols, Amy A. RN, CNS, EdD

The Journal of Perinatal & Neonatal Nursing: July-September 2005 - Volume 19 - Issue 3 - p 217–225
Feature Article: Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy is a rare disorder, predominately occurring during the third trimester of pregnancy and characterized by pruritis, jaundice, and biochemical disturbances in liver enzymes. While intrahepatic cholestasis of pregnancy poses little maternal risk, there is significant risk to the fetus such as preterm delivery, nonreassuring fetal status, meconium staining, and perinatal mortality. Current evidence proposes susceptibility to derangements in the sulfation of steroid compounds, affecting the metabolism of progesterone and bile acids in the fetal/placental compartment. Treatment with ursodeoxycholic acid is suggested, coupled with close maternal-fetal surveillance and delivery as close to term as possible.

School of Nursing, San Francisco State University, San Francisco, Calif.

Corresponding author: Amy A. Nichols, RN, CNS, EdD, School of Nursing, San Francisco State University, San Francisco, CA 94132 (e-mail: anichols@sfsu.edu).

Submitted for publication: July 6, 2004; Accepted for publication: September 2, 2004

© 2005 Lippincott Williams & Wilkins, Inc.