title: Management of intrahepatic cholestasis of pregnancy.
abstract: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease during pregnancy, characterized by otherwise unexplained pruritus in late second and third trimester of pregnancy and elevated bile acids and/or transaminases. ICP is associated with an increased risk of adverse perinatal outcomes for the fetus and the later development of hepatobiliary disease for the mother. Bile acids should be monitored throughout pregnancy since fetal risk is increased at serum bile acids >40 µmol/l. Management of ICP consists of treatment with ursodeoxycholic acid, which reduces pruritus. Early elective delivery is common practice but should be performed on an individualized basis as long as strong evidence supporting this practice is lacking. Mothers should be followed-up for normalization of liver function tests 6-12 weeks after delivery. Future research in large-scale studies is needed to address the impact of ursodeoxycholic acid and early elective delivery on fetal outcome.
authors: a Department of Molecular and Clinical Medicine, University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, S-41345 Gothenburg, Sweden.
authors: Hanns-Ulrich
authors: HU
authors: Marschall
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001647:Bile Acids and Salts / Q000097:blood; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000150:complications / Q000628:therapy*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007751:Labor, Induced; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000628:therapy*; D047928:Premature Birth / Q000209:etiology; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology; D012293:Rifampin / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*; D014812:Vitamin K / Q000627:therapeutic use
chemical_list: D000933:Antifibrinolytic Agents; D001647:Bile Acids and Salts; D002756:Cholagogues and Choleretics; D006633:Histamine Antagonists; D019384:Nucleic Acid Synthesis Inhibitors; D014812:Vitamin K; D014580:Ursodeoxycholic Acid; D012293:Rifampin
keywords: bile acids; early delivery; obstetric cholestasis; progesterone sulfates; ursodeoxycholic acid