Intrahepatic cholestasis of pregnancy: a past and present riddle.
Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific disorders that occurs mainly in the third trimester of pregnancy and is characterized by pruritus and elevated bile acid levels. ICP is regarded as a benign disease with no meaningful consequences to the mother but associated to an increased perinatal risk with increased rates of fetal morbidity and mortality. The pathogenesis of disease is unknown but likely involves a genetic hypersensitivity to estrogen or estrogen metabolites. Mutations or polymorphisms of some hepatobiliary transport proteins may contribute to disease pathogenesis or severity. Treatment is focused on a) reducing symptoms in the mother and b) to provide an adequate obstetric management in order to prevent fetal distress. Currently, only Ursodeoxycholic acid treatment has been proven to be useful and should be considered mainly in patients with severe pruritus or complications in previous pregnancies.
Arrese
Marco
M
Departamento de Medicina, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. marrese@med.puc.cl
Reyes
Humberto
H
D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D002780:Cholestasis, Intrahepatic / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid