Intrahepatic cholestasis of pregnancy is the most common pregnancy-specific liver disease that typically presents in the third trimester. The clinical features are maternal pruritus in the absence of a rash and deranged liver function tests, including raised serum bile acids. Intrahepatic cholestasis of pregnancy is associated with an increased risk of adverse perinatal outcomes, including spontaneous preterm delivery, meconium staining of the amniotic fluid, and stillbirth. It is commonly treated with ursodeoxycholic acid. There is accumulating evidence to suggest that intrahepatic cholestasis of pregnancy has a lasting influence on both maternal and fetal health. We review the etiology, diagnosis, and management of this intriguing condition.
Intrahepatic cholestasis of pregnancy causes pruritus, deranged liver function, and raised serum bile acids and is associated with an increased risk of adverse perinatal outcomes.Supplemental Digital Content is Available in the Text.
Women's Health Academic Centre, King's College London, and Department of Obstetrics and Gynaecology, University College London, London, United Kingdom.
Corresponding author: Catherine Williamson, MD, Professor of Women's Health, Women's Health Academic Centre, King's College London, Guy's Hospital Campus, London, U.K.; e-mail: firstname.lastname@example.org.
Continuing medical education for this article is available at http://links.lww.com/AOG/A523.
Financial Disclosure The authors did not report any potential conflicts of interest.