Diagnosis and therapy of intrahepatic cholestasis of pregnancy

Zeitschrift für Gastroenterologie
T C PausChristoph Reichel

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is characterized by the occurrence of pruritus mostly in the third trimenon. Diagnosis is based on the presence of pruritus and elevated levels of serum bile acids in the absence of pruritic skin diseases. There is strong evidence of a genetic predisposition for ICP. Numerous studies have investigated the association of known cholestasis genes such as ABCB4 (also designated MDR3), ABCB11 ( BSEP) and ATP8B1 ( FIC1) with ICP. The results of these studies implicate a heterogeneous etiology of this syndrome. ICP increases the risk of preterm delivery and fetal loss. Furthermore, intense pruritus may necessitate premature induction of labor with its known higher frequency of complications for mother and child. Therefore, ICP pregnancies should be managed as high-risk pregnancies. Pharmaceuticals to alleviate pruritus or improve cholestasis like antihistamines, phenobarbital, anion exchange resins, dexamethasone or S-adenosylmethionine are not widely accepted because of questionable efficacy or side effects. Recent randomized studies have shown beneficial effects of ursodeoxycholic acid (UDCA) on laboratory data and pruritus in patients with ICP. Improved knowledge about the diagnostic clas...Continue Reading

Citations

Apr 20, 2006·Pflügers Archiv : European journal of physiology·Ronald P J Oude Elferink, Coen C Paulusma
Mar 7, 2009·World Journal of Gastroenterology : WJG·Winita HardikarPeter Angus
Oct 2, 2012·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Claudia AnzivinoLucia Carulli
Dec 26, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Gudrun SchneiderChristoph Reichel
Mar 15, 2006·Gastroenterology·Ronald P J Oude ElferinkAlbert K Groen

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