title: [Intrahepatic cholestasis of pregnancy--four case reports].
abstract: OBJECTIVE
  To draw attention to the role of elevated levels of bile acids and liver enzymes in intrahepatic cholestasis of pregnancy (ICP) on the course of pregnancy. Literary overview of the complications associated with ICP.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Department of Obstetrics and Gynecology, Regional Hospital, Pardubice.
  
  
  METHODS
  The author analyses four cases of highly elevated liver enzymes in late pregnancy. Together with statements in literature she describes the recommendations for the best management of ICP to prevent poor fetal outcome including intrauterine fetal demise, increased incidence of meconium-stained amniotic fluid and fetal intolerance of labour.
  
  
  CONCLUSIONS
  Fetal mortality appears to be secondary to acute anoxic events, rather than chronic utero-placental insufficiency. Early delivery when indicated appears the only strategy currently demonstrated to improve outcomes. The levels of bile acids can help the clinicians to make the decision.
authors.affiliation: Gynekologicko-porodnické oddelení Krajské nemocnice Pardubice.
authors.forename: Z
authors.initials: Z
authors.lastname: Kokrdová
mesh_terms: D000328:Adult; D002780:Cholestasis, Intrahepatic / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy