Intrahepatic Cholestasis of Pregnancy: A Case Report of Third-Trimester Onset of the Disease

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is characterized by pruritus and an elevation in serum bile acid concentrations, typically developing in the late second and/or the third trimester and rapidly resolving after delivery. ICP is a rare condition that most often presents in the late second or early third trimesters of pregnancy. Physicians should be aware of this unusual presentation of ICP and screen their patients appropriately during prenatal consultations by monitoring symptom severity and laboratory tests, including bile acids and liver enzyme levels, in addition to monitoring the fetal condition to start treatment modality including maternal treatment and determine the time of delivery to avoid fetal complications. This is a case of severe ICP diagnosed in the late second trimester and went into labor at 33 weeks of gestational age.

Keywords: bile acids; cholestasis; intrahepatic cholestasis; intrahepatic cholestasis of pregnancy; pregnancy; pruritus; third trimester.

Figure 1. Antenatal ultrasound