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Intrahepatic Cholestasis of Pregnancy
Shital Gandhi1, Brianna Barsanti-Innes1, Gisele Jolicoeur1
1Department of Medicine, Division of General Internal and Obstetric Medicine, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
Clinics in Liver Disease
|July 22, 2026
Summary
Intrahepatic cholestasis of pregnancy (ICP) is a common pregnancy-related liver disorder causing itching, typically in late pregnancy. Prompt diagnosis and management are crucial due to potential fetal risks.
Area of Science:
- Hepatology
- Obstetrics
- Perinatology
Background:
- Intrahepatic cholestasis of pregnancy (ICP) is the most frequent pregnancy-induced liver disease.
- Characterized by pruritus (itching), it usually begins in the third trimester.
- Hormonal influences, particularly estrogen and progesterone, are implicated in its etiology.
Purpose of the Study:
- To review the characteristics, diagnosis, and management of intrahepatic cholestasis of pregnancy.
- To highlight the importance of considering underlying cholestatic conditions.
- To emphasize the potential fetal risks associated with severe ICP.
Main Methods:
- This is a review of existing literature and clinical understanding.
- Diagnosis is based on clinical presentation and exclusion of other liver diseases.
- Key diagnostic indicators include pruritus and elevated bile acids.
Main Results:
- ICP presents with pruritus, often starting in the second or third trimester.
- It is a diagnosis of exclusion, requiring consideration of other liver conditions.
- Severe cases are linked to significant fetal morbidity and mortality.
Conclusions:
- ICP is a common pregnancy complication requiring careful diagnosis.
- Early onset or severe symptoms warrant investigation for unmasked cholestatic disorders.
- Management is critical to mitigate risks to both mother and fetus.
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