New Insights on Intrahepatic Cholestasis of Pregnancy

Clin Liver Dis. 2016 Feb;20(1):177-89. doi: 10.1016/j.cld.2015.08.010. Epub 2015 Oct 9.

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is characterized by maternal pruritus, and elevated serum transaminases and bile acids. Genetic defects in at least 6 canalicular transporters have been found. Association studies stress the variability of genotypes, different penetrance, and influence of environmental factors. Serum autotaxin is a sensitive, specific, and robust diagnostic marker. Elevated maternal bile acids correlate with fetal complications. Long-term sequelae for mothers include the gallstone risk and chronic liver disease. There is an association between ICP and hepatitis C. Current treatment is ursodeoxycholic acid, owing to benefits on pruritus, liver function, safety, and decreased rates of adverse effects.

Keywords: Bile salts; Cholelithiasis; Intrahepatic cholestasis of pregnancy; Itching; Ursodeoxycholic acid.

Publication types

  • Review

MeSH terms

  • Bile Acids and Salts / blood
  • Cholagogues and Choleretics / therapeutic use*
  • Cholestasis, Intrahepatic / blood
  • Cholestasis, Intrahepatic / drug therapy*
  • Cholestasis, Intrahepatic / epidemiology
  • Cholestasis, Intrahepatic / genetics
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / genetics
  • Pregnancy Outcome*
  • Risk Factors
  • Ursodeoxycholic Acid / therapeutic use*

Substances

  • Bile Acids and Salts
  • Cholagogues and Choleretics
  • Ursodeoxycholic Acid

Supplementary concepts

  • Intrahepatic Cholestasis of Pregnancy