[INTRAHEPATIC CHOLESTASIS OF PREGNANCY: STATE-OF-THE-ART]

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is a relatively benign cholestatic pathology of the liver developing in II or III trimester of pregnancy and characterized by itchy skin and enhanced serum bile acid levels. The cause of ICP is unknown; it may have a multifactor nature involving genetic (ABCB4, EXR, ABCC2 genes), hormonal (estrogens, progesterone), and environmental factors. As a rule, ICP first manifests itself on weeks 28-30 of pregnancy in the form of pruritus especially pronounced at night time. Almost half of the patients develop jaundice, usually within 1-4 weeks after appearance of pruritus. The enhanced serum bile acid level is sometimes the first or the sole laboratory sign of the disease. Ursodeoxycholic acid is currently the drug of choice for the treatment of ICP due to its confirmed effectiveness and safety.