Intrahepatic cholestasis of pregnancy

Publication date: Available online 17 November 2018Source: Current Medicine Research and PracticeAuthor(s): Sunita Kumar, Pankaj Puri, K. GujralAbstractIntrahepatic cholestasis of pregnancy (IHCP) is a liver disorder occurring mostly in the second or third trimester of pregnancy, characterised with the development of pruritis without any skin rash, but with raised bile acids and transaminase levels and altered bile acid metabolism. These usually return to normal post delivery.Incidence of IHCP has a wide geographical variation depending on different environmental conditions, ethnicity and genetic susceptibility. It ranges from less than 1%–27.6%.Raised liver functions in intra hepatic cholestasis of pregnancy has a diagnostic dilemma. Diagnosis of IHCP depends on various biochemical tests and exclusion of other liver disorders in pregnancy.Altered bile acid metabolism with accumulation of bile acid is detrimental to the fetus leading to increased perinatal morbidity and mortality in the form of preterm births, meconium, fetal distress and stillbirths or intra uterine death.Pharmacological treatment with Ursodeoxycholic acid improves pruritis and stabilises the liver functions.A better understanding of the disease with early detection, interdisciplinary approach and prompt delivery at fetal maturity has improved perinatal outcome over the years.
Source: Current Medicine Research and Practice - Category: General Medicine Source Type: research