Intrahepatic cholestasis of pregnancy

Abstract

P.V. Kozlov1, I.V. Samsonova2 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2City Clinical Hospital No. 52, Moscow, Russian Federation Intrahepatic cholestasis of pregnancy (ICP) is a reversible form of cholestasis which occurs in pregnant women and manifests with itchy skin, elevated serum bile acids and/or liver enzymes, and postnatal spontaneous resolution (within 2 to 6 weeks) without any other causes. The paper addresses recent data on the etiology, pathogenesis, and diagnostic markers of ICP. Pregnancy management algorithms (including fetal functional monitoring) to minimize the risks of prenatal morbidity and mortality are described. Diagnostic criteria for intrahepatic cholestasis of pregnancy, the importance of the changes in liver enzyme activity, and differential diagnostic aspects of pregnancy complications associated with higher risks of maternal death (i.e., preeclampsia, acute fatty liver of pregnancy, HELLP syndrome etc.) are highlighted. Pharmacotherapy for ICP as well as obstetric management approaches including terms and methods of delivery are discussed considering recent domestic and fore ign published data and guidelines provided by professional healthcare societies. Keywords: pregnancy, cholestasis of pregnancy, intrahepatic cholestasis, liver enzymes, treatment. For citation: Kozlov P.V., Samsonova I.V. Intrahepatic cholestasis of pregnancy. Russian Journal of Woman and Child Health. 2019;2(4):274–279.