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Intrahepatic Cholestasis of Pregnancy

A pregnancy-specific liver disorder presenting with severe itching and elevated bile acids.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Intrahepatic Cholestasis of Pregnancy?

Intrahepatic cholestasis of pregnancy (ICP) is a transient liver pathology that occurs when pregnancy hormones disrupt hepatobiliary transport, allowing bile acids to enter the systemic circulation. Diagnosis is made with serum total bile acid level >10 μmol/L.

The disease usually manifests after the 28th week of pregnancy, with itching that begins on the palms and soles and increases at night. There is no rash; scratch marks (excoriation) are prominent. Liver enzymes and bilirubin may rise mildly.

While maternal prognosis improves rapidly after delivery, fetal risk is high: spontaneous preterm birth, abnormal fetal heart rhythm, meconium-stained amniotic fluid and unexpected intrauterine fetal death have been reported. Follow-up and timely delivery are critical.

Symptoms

Severe itching of the palms and soles
Increased itching at night
Darkening of urine color
Nausea and loss of appetite
Right upper quadrant discomfort
Mild jaundice (in a minority of cases)

Risk Factors

History of cholestasis in previous pregnancy
Multiple pregnancy and IVF-conceived pregnancy
Family history of cholestasis
Hepatitis C infection
Chronic liver disease
South American and Scandinavian origin

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When persistent palm itching without rash develops in pregnancy
  • When darkening of urine and lightening of stool color is noticed
  • When sleep is disturbed due to itching
  • Re-presentation in a pregnant woman with previous ICP diagnosis
  • When decreased fetal movements are felt

Treatment Methods

01
Follow-up of serum total bile acids and liver enzymes
02
Ursodeoxycholic acid treatment
03
Symptomatic support with skin care and antihistamines
04
Frequent fetal monitoring and biophysical profile
05
Delivery at 37 weeks or earlier if bile acids are very high
06
Confirmation of postpartum return of liver function to normal

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.