Intrahepatic cholestasis of pregnancy - Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

Affiliations

¹ Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
² Women's Health & Midwifery Research, College of Nursing & Health Sciences, Bedford Park, South Australia, Australia.
³ Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
⁴ School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia.
⁵ Department of Obstetrics and Gynaecology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
⁶ King Edward Memorial Hospital, Subiaco, Western Australia, Australia.
⁷ College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia.
⁸ Liverpool Hospital, Sydney, New South Wales, Australia.
⁹ SA Health and Medical Research Institute, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
¹⁰ College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.
¹¹ Department of Maternal Fetal Medicine, Royal Hospital for Women, Randwick, New South Wales, Australia.
¹² Women's and Children's Health, The University of Adelaide, Adelaide, South Australia, Australia.
¹³ Auckland City Hospital, Auckland, New Zealand.

PMID: 37431680
DOI: 10.1111/ajo.13719

Intrahepatic cholestasis of pregnancy - Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

William M Hague et al. Aust N Z J Obstet Gynaecol. 2023 Oct.

. 2023 Oct;63(5):656-665.

doi: 10.1111/ajo.13719. Epub 2023 Jul 11.

Authors

Affiliations

¹ Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia.
² Women's Health & Midwifery Research, College of Nursing & Health Sciences, Bedford Park, South Australia, Australia.
³ Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
⁴ School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Queensland, Australia.
⁵ Department of Obstetrics and Gynaecology, Flinders Medical Centre, Bedford Park, South Australia, Australia.
⁶ King Edward Memorial Hospital, Subiaco, Western Australia, Australia.
⁷ College of Medicine & Public Health, Flinders University, Bedford Park, South Australia, Australia.
⁸ Liverpool Hospital, Sydney, New South Wales, Australia.
⁹ SA Health and Medical Research Institute, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
¹⁰ College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.
¹¹ Department of Maternal Fetal Medicine, Royal Hospital for Women, Randwick, New South Wales, Australia.
¹² Women's and Children's Health, The University of Adelaide, Adelaide, South Australia, Australia.
¹³ Auckland City Hospital, Auckland, New Zealand.

PMID: 37431680
DOI: 10.1111/ajo.13719

Abstract

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy liver disease, characterised by pruritus and increased total serum bile acids (TSBA), Australian incidence 0.6-0.7%. ICP is diagnosed by non-fasting TSBA ≥19 μmol/L in a pregnant woman with pruritus without rash without a known pre-existing liver disorder. Peak TSBA ≥40 and ≥100 μmol/L identify severe and very severe disease respectively, associated with spontaneous preterm birth when severe, and with stillbirth, when very severe. Benefit-vs-risk for iatrogenic preterm birth in ICP remains uncertain. Ursodeoxycholic acid remains the best pharmacotherapy preterm, improving perinatal outcome and reducing pruritus, although it has not been shown to reduce stillbirth.

Keywords: pregnancy; pruritus; stillbirth; total serum bile acids; ursodeoxycholic acid.

© 2023 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

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References

REFERENCES

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1. Marathe JA, Lim WH, Metz MP et al. A retrospective cohort review of intrahepatic cholestasis of pregnancy in a South Australian population. Eur J Obstet Gynecol Reprod Biol 2017; 218: 33-38.
1. Ovadia C, Seed PT, Sklavounos A et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: Results of aggregate and individual patient data meta-analyses. Lancet 2019; 393: 899-909.
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Intrahepatic cholestasis of pregnancy - Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

Affiliations

Intrahepatic cholestasis of pregnancy - Diagnosis and management: A consensus statement of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ): Executive summary

Authors

Affiliations

Abstract

References

REFERENCES

LinkOut - more resources

Full Text Sources