[Intrahepatic cholestasis of pregnancy: review]

Abstract

The etiology of intrahepatic cholestasis of pregnancy includes genetic and environmental factors. Bile acids elevation in maternal and fetal blood is the main fact of its physiopathology, causing maternal itching and high perinatal morbidity and mortality. High levels of maternal blood bile acids are diagnostic. Best treatment is ursodeoxycolic acid and clearly it produces amelioration of bile acid levels and itching, but it is uncertain if it reduces perinatal morbidity and mortality. As far as fetal death is one of sudden onset, probably due to acute hypoxia, tests to evaluate and predict fetal condition are useless. Pregnancy interruption at 36-37 gestation weeks is the best strategy for lowering fetal death incidence. The purpose of this work is to achieve an actualized literature review on this disease.