[Cholestasis of pregnancy].
Intrahepatic cholestasis of pregnancy (ICP) is a reversible cholestatic liver disease that may develop during the second or third trimester of pregnancy and resolves rapidly after delivery. The chief complaint is pruritus. Serum liver tests reveal moderate cholestasis with increased levels of bile salts (> or = 10 micromol/l) and aminotransferases. The pathogenesis of ICP is multifactorial. Potential contributors include a genetic predisposition interacting with the effects of estrogen and progesterone metabolites on bile secretory mechanisms, as well as environmental factors. ICP may cause fetal distress, with stillbirths or premature deliveries, leading to increased perinatal morbidity and mortality. Several drugs have been used for ICP treatment. The available evidence suggests that the most effective therapy is ursodeoxycholic acid, since this drug improves pruritus and liver function tests without maternal or fetal toxicity.
Lorente
Sara
S
Unidad de Gastroenterología y Hepatología. Hospital San Jorge de Huesca. Huesca. España. slorente@salud.aragon.es
Montoro
Miguel A
MA
D001646:Bile / Q000378:metabolism; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002792:Cholestyramine Resin / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005316:Fetal Distress / Q000209:etiology; D020022:Genetic Predisposition to Disease; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006801:Humans; D015994:Incidence; D008111:Liver Function Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011256:Pregnancy Outcome; D011537:Pruritus / Q000209:etiology; D012307:Risk Factors; D012436:S-Adenosylmethionine / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D002756:Cholagogues and Choleretics; D012739:Gonadal Steroid Hormones; D002792:Cholestyramine Resin; D014580:Ursodeoxycholic Acid; D012436:S-Adenosylmethionine; D003907:Dexamethasone