Intrahepatic Cholestasis of Pregnancy

Intrahepatic cholestasis of pregnancy is the most common liver disorder induced by pregnancy. It is characterized by pruritus, with onset typically at the end of the second trimester. Etiology is likely related to effects of estrogen and progesterone. It is a diagnosis of exclusion, and underlying cholestatic conditions that are potentially unmasked by pregnancy need to be considered, especially if onset in pregnancy is early, or if symptoms and bile acid elevation are particularly severe. The spectrum of disease varies from mild to clinically morbid pruritus with associated fetal morbidity and even mortality.