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Am J Perinatol 2014; 31(01): 001-008
DOI: 10.1055/s-0033-1333673
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Clinical Approach to Intrahepatic Cholestasis of Pregnancy

Zaid Diken
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Ihab M. Usta
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Anwar H. Nassar
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
› Author Affiliations
Further Information

Publication History

18 October 2012

28 November 2012

Publication Date:
28 January 2013 (online)

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Abstract

Intrahepatic cholestasis of pregnancy (ICP) has a varying prevalence worldwide. The etiology behind this disease remains not fully understood with multiple factors influencing its development including genetic variations, dietary factors, hormonal changes, and environmental influences. Presenting mainly during the third trimester with generalized itching and resolving spontaneously postpartum, this condition is still associated with fetal morbidity and mortality. The diagnosis is based on clinical presentation in association with biochemical abnormalities. Elevation in total bile acid levels is the most frequent laboratory abnormality and seems to be the most important for gauging further management of the disease. The most appropriate gestational age for the delivery of women with ICP is yet to be determined. In this review we discuss the epidemiology, clinical features, diagnosis, etiology, and management of ICP, trying to shed light on some controversial aspects of the disease.

Keywords

intrahepatic cholestasis of pregnancy - epidemiology - etiology - diagnosis - management
 

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