[Uncomplicated pregnancy in patients with unrecognized primary biliary cirrhosis]

A 32 yr-old woman suffering from an unsuspected primary biliary cirrhosis (PBC), completed an uneventual pregnancy. She only experienced diffuse pruritus and subicterus, which misled to an antepartum diagnosis of intrahepatic cholestasis of pregnancy. The most remarkable points of the reported case are: (a) the younger age of onset of PBC; (b) the paucisymptomatic course of PBC; (c) the rarity of PBC-associated pregnancy (only 15 previous instances in 12 patients, from a review of the literature); (d) the uncomplicated course of pregnancy for both the mother and the fetus, which is the exception rather than the rule, in such a condition. The present observation calls our attention to the possible existence of an underlying latent liver cirrhosis in pregnant women with pruritus, jaundice and mild alterations of liver function indexes. This association, which is expected to increase in frequency in the near future, may have important implications in the management of pregnancy.