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Intrahepatic cholestasis of pregnancy: Introduction and overview 2024
Wm Bill Hague1, Catherine Williamson2, Ulrich Beuers3
1Robinson Research Institute, The University of Adelaide, North Adelaide, Australia.
Obstetric Medicine
|September 12, 2024
Summary
Intrahepatic cholestasis of pregnancy (ICP) can be identified using total serum bile acid (TSBA) thresholds, aiding in managing stillbirth and preterm birth risks. Ursodeoxycholic acid may prevent preterm birth, and prior ICP warrants screening for hepatobiliary disease.
Area of Science:
- Obstetrics and Gynecology
- Hepatology
- Maternal-Fetal Medicine
Background:
- Intrahepatic cholestasis of pregnancy (ICP) is linked to adverse pregnancy outcomes.
- High maternal total serum bile acids (TSBAs) are a key indicator.
Purpose of the Study:
- To establish TSBA thresholds for identifying high-risk pregnancies.
- To evaluate ursodeoxycholic acid for preventing spontaneous preterm birth.
- To guide management for women with a history of ICP.
Main Methods:
- Analysis of non-fasting TSBA levels in relation to pregnancy outcomes.
- Review of data supporting ursodeoxycholic acid efficacy.
- Assessment of risks for hepatobiliary disease following ICP.
Main Results:
- Specific non-fasting TSBA thresholds correlate with stillbirth and preterm birth risks.
- Ursodeoxycholic acid shows potential in reducing spontaneous preterm birth.
- Previous ICP may increase susceptibility to future hepatobiliary conditions.
Conclusions:
- TSBA thresholds aid in risk stratification and intervention for ICP.
- Ursodeoxycholic acid is a potential therapeutic option for ICP.
- Screening for genetic and associated disorders is recommended for women with ICP history.
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